Perspective:

This retrospective, administrative hospital-discharge database review between 2010 and 2019 in France found that ViV TAVR was associated with better short-term outcomes using a combined endpoint of all-cause mortality, all-cause stroke, MI, and major or life-threatening bleeding compared to redo SAVR for bioprosthetic aortic valve failure; and similar longer-term outcomes using a composite endpoint of cardiovascular death, all-cause stroke, MI, or rehospitalization for heart failure. However, longer-term rates of pacemaker implantation and rehospitalization for heart failure occurred more frequently after ViV TAVR. Aside from the inherent limitations and biases associated with a retrospective review based on an administrative database, additional confounders may exist in terms of two time-dependent phenomena: an increase in experience with TAVR, and a decline in patient risk, as the use of TAVR progressively penetrated moderate- and low-risk populations. Although not without its limitations, this study provides further data to support the use of ViV TAVR among appropriate patients with structural deterioration of an aortic valve bioprosthesis.