Cardiac Reoperations in Patients with Transcatheter Aortic Bioprosthesis

In forty-eight consecutive patients undergoing explants of transcatheter aortic valve replacement (TAVR) at a single center between 2011 and 2021, at a median of 2.3 years after TAVR, the most common indications for surgery were nonstructural valve dysfunction (patient-prosthesis mismatch or paravalvular leak) in 35 percent, structural valve deterioration in 29 percent, and mitral valve disease in 29 percent. The authors describe that TAVR valves were typically easily removed; however, unplanned aortic root replacement because of aortic root trauma during explantation was required in four patients, and root enlargement was required in four patients. Overall operative mortality was 15 percent.