Early and Midterm Clinical Outcomes of Transcatheter Valve in Valve Implantation Versus Redo Surgical Aortic Valve Replacement for Aortic Bioprosthetic Valve Degeneration. Two faces of the same medal

Objective. To compare early and midterm outcomes of transcatheter valve-in-valve (ViV-TAVI) and redo surgical aortic valve replacement (re-SAVR) for aortic bioprosthetic valve degeneration. Design. Patients who underwent ViV-TAVI and re-SAVR for aortic bioprosthetic valve degeneration between January 2010 and October 2018 were retrospectively analyzed. Mean follow-up was 3.0 years. Setting. In-hospital, early and mid-term outcomes. Participants. 88 patients were included in the analysis. Interventions. 31 (37.3%) patients had ViV-TAVI and 57 patients had (62.7%) re-SAVR. Measurements and main results. In the ViV-TAVI group, patients were older (79.1 ± 7.4 vs 67.2 ± 14.1, p<0.01). The total operative time, the intubation time, intensive care unit length of stay, total hospital length of stay, inotropes infusion, intubation > 24 hours, total amount of chest tube losses, red blood cells transfusions, plasma transfusions and reoperation for bleeding were significantly higher in the re-SAVR cohort (p<0.01). There was no difference regarding in-hospital permanent pacemaker implantation (ViV-TAVI=3.2% vs re-SAVR=8.8%,p=0.27), patient-prosthesis mismatch [ViV-TAVI=12 patients (mean 0.53 ± 0.07) and re-SAVR=10 patients (mean 0.56 ± 0.08), p=0.4], stroke (ViV-TAVI=3.2% vs re-SAVR=7%, p=0.43, acute kidney injury (ViV-TAVI=9.7% vs re-SAVR=15.8%, p=0.1), all cause infections (ViV-TAVI=0% vs re-SAVR=8.8%, p=0.02), between the two groups. In-