title: Redo TAVI: initial experience at two German centres.
abstract: OBJECTIVE
  The aim of this study was to assess the feasibility and early outcomes of transcatheter aortic valve implantation (TAVI) in dysfunctional TAVI prostheses (redo TAVI).
  
  
  RESULTS
  Nineteen redo TAVI procedures were performed between October 2011 and November 2015 at two German centres. Mean age was 78 years, 13 (68%) were male, and the mean logistic EuroSCORE was 32%. Median time elapsed since index TAVI was 644 days (interquartile range 191-1,831). Failure mode of the index TAVI prosthesis was regurgitation (AR) in 16 patients (n=12 paravalvular AR, n=3 combined paravalvular/valvular AR, n=1 valvular AR) and stenosis in three patients. Device success was achieved in 89% (17/19). Median invasive post-interventional transprosthetic gradient was 3.0 mmHg. No severe prosthesis-patient mismatch (PPM) was observed. At one year, mean pressure gradient was 9±1.2 mmHg and no relevant PPM was documented in 90% of the cases. All-cause mortality at 30 days and one year was 11% and 33% (6/18, five non-cardiac deaths), respectively. Mean follow-up time was 404 days.
  
  
  CONCLUSIONS
  Redo TAVI appears to be feasible. Paravalvular regurgitation was the most common indication for a redo procedure. Rates of device success were high with low post-interventional gradients and no severe PPM. Good functional status of the prosthesis was maintained after 12 months, but mortality rates were high in this small comorbid patient population.
authors.affiliation: Department of Cardiology, Asklepios Klinik St. Georg Hospital, Hamburg, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Schmidt
authors.forename: Christian
authors.initials: C
authors.lastname: Frerker
authors.forename: Hannes
authors.initials: H
authors.lastname: Alessandrini
authors.forename: Michael
authors.initials: M
authors.lastname: Schlüter
authors.forename: Felix
authors.initials: F
authors.lastname: Kreidel
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schäfer
authors.forename: Thomas
authors.initials: T
authors.lastname: Thielsen
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.forename: John
authors.initials: J
authors.lastname: Jose
authors.forename: Erik W
authors.initials: EW
authors.lastname: Holy
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Mawardy
authors.forename: Abdelhakim
authors.initials: A
authors.lastname: Allali
authors.forename: Gert
authors.initials: G
authors.lastname: Richardt
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Wahab
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D065467:Transcatheter Aortic Valve Replacement / Q000706:statistics & numerical data*