Rates of redo transcatheter aortic valve replacement (TAVR) and TAVR explant are on the rise in patients with aortic stenosis (AS), a brief report shows. When TAVR reintervention is performed 5 years or later after the initial procedure, the procedure usually involves redo TAVR rather than TAVR explant. Maxwell C. Braasch, MD, MPH, from the Washington University in St Louis, Missouri, and colleagues, reported the corresponding data in a manuscript published Wednesday online in JAMA Cardiology. Reintervention by TAVR means patients undergo either redo TAVR or TAVR explant. Which of these is performed more often is unclear. Data for this retrospective analysis were collected from the U.S. Centers for Medicare and Medicaid Services Virtual Research Data Center between January 2012 and June 2024. This study compared patients with AS who underwent TAVR initially and had either follow-up redo TAVR, the redo TAVR group, or SAVR. SAVR after TAVR comprised the TAVR explant group. The investigators also examined rates of SAVR reintervention for a comprehensive assessment of aortic valve replacements in this patient population. Patients who received TAVR after SAVR were the valve-in-valve (ViV) TAVR group. SAVR after SAVR defined the redo SAVR group. Annual incidence and procedural volume of redo TAVR and TAVR explant was the primary outcome in the trial. The same outcomes for SAVR were the secondary outcomes. A total of 410,720 TAVRs took place between 2012 and 2024 in this patient population, with 2,374 redo TAVRs and 1,346 TAVR explants. As for SAVR, 299,780 procedures occurred during this time, which included 5,044 ViV-TAVRs and 4,202 redo SAVRs. Many redo TAVRs and TAVR explants took place since 2020 (n=1,518 and n=1,007). The incidence of TAVR reintervention increased from 2018 (0.17%) to 2023 (0.28%). Most commonly, redo TAVR took place within 3 months after the initial TAVR procedure (17.3%). TAVR explant was most performed 1-2 years after the initial procedure (19.2%). After 5 years, most patients undergoing reintervention received redo TAVR (88.5%) over TAVR explant. For redo SAVR procedures, the annual procedural volume decreased from 2019 to 2024 (436 to 356). ViV TAVR procedures continued to increase annually. SAVR reintervention for the entire cohort did increase slightly, from 0.24% in 2014 to 0.73% in 2023. Overall, the number of redo TAVR and TAVR explant procedures has increased, especially since 2020. After 5 years, most patients receiving reintervention have redo TAVR and not TAVR explant. Source: Braasch MC, Pyeatte SR, He J, et al. Contemporary and procedural volume of transcatheter aortic valve reintervention. JAMA Cardiol. 2025 September 24 (Article in press). Image Credit: Yurii Kibalnik – stock.adobe.com