Repeat Transcatheter Aortic Valve Implantation All That Glitters Is Not Gold...Yet

摘要

With the increasing number of younger patients undergoing a mini-invasive transcatheter therapy for severe aortic stenosis, repeat interventions after transcatheter aortic valve implantation (TAVI) due to valve degeneration are expected to rise dramatically in the next future. To date, this is a rare procedure, accounting for <0.5% of cases in TAVI centers, but it is important to start raising questions on what could be the best approach to transcatheter aortic valves (TAVs) degeneration, in terms of preprocedural screening, procedural techniques, and postprocedural considerations. Although data are currently very limited, in general, TAVI-in-TAVI procedures seem to be safe, with low rates of periprocedural complications and midterm survival comparable to most recent TAVI series. This is definitely a good start, but it is not sufficient to consider redo TAVI a well-standardized procedure, as TAVI is for either native aortic stenosis or surgical aortic valve degeneration.