THE NUMBER of people requiring transcatheter aortic valve reinterventions (TAVR) is steadily increasing in the United States, reflecting the broader adoption of transcatheter aortic valve replacement. The latest data show that redo TAVR is now the most common reintervention several years after the initial procedure.
National Trends in TAVR Reintervention
TAVR, a minimally invasive approach to treating aortic stenosis, has become standard in patients at all risk levels. As more patients live longer after TAVR, attention is turning to the long-term management of replaced valves. In a national analysis covering over 410,000 TAVR procedures from 2012 to 2024, there were 2,374 redo TAVRs and 1,346 TAVR explants, with annual incidence rising from 0.17% in 2019 to 0.28% in 2023. Redo TAVR after five years accounted for almost 90% of late reinterventions, highlighting this as a growing clinical consideration.
Comparing Redo TAVR, Explant, and SAVR
The most common time for redo TAVR was within three months of the original procedure (17.3%), while most TAVR explants occurred between one and two years after the initial implant. Since 2020, over half of the total redo TAVR and TAVR explant procedures have taken place, reflecting increasing procedural volume. For comparison, 299,780 surgical aortic valve replacements (SAVR) were analysed, showing similar trends in valve-in-valve and redo operations, though TAVR is rapidly overtaking SAVR for reintervention.
TAVR Into the Future
As TAVR becomes more common for younger and lower-risk patients, the need for effective strategies for redo TAVR and TAVR explant will only grow. Ongoing research aims to identify the best reintervention approaches for different patient profiles and to refine operative and device techniques. With increasing lifetime exposure to TAVR, clinicians must plan for the inevitability of valve failure and the need for subsequent interventions to ensure long-term outcomes
Reference
Braasch MC et al. Contemporary incidence and procedural volume of transcatheter aortic valve reintervention. JAMA Cardiol. 2025;DOI:10.1001/jamacardio.2025.3224.
