Transcatheter Aortic Valve Explant Experience From a High-Volume Structural Heart Center

Background: When transcatheter aortic valve replacement (TAVR) fails and repeat TAVR is not possible, TAVR explantation remains a viable strategy. However, results from multicenter studies have shown high morbidity and mortality. This study aimed to examine early and late outcomes after TAVR explantation at a high-volume structural heart center. Methods: At a single center performing >600 TAVR procedures annually, the institutional The Society of Thoracic Surgeons registry was queried to identify all patients undergoing surgical aortic valve replacement with a history of TAVR between 2011 and 2024. Institutional trends, operative details, and outcomes at 30-days and 5-years were compared between TAVR explantation with isolated surgical aortic valve replacement (SAVR; n = 14) and TAVR explantation with SAVR plus concomitant procedures (n = 40). Results: = .47) between the isolated SAVR and concomitant procedures groups. Conclusions: The risk of morbidity and mortality was relatively low in patients undergoing TAVR explantation in a single high-volume center, a finding highlighting the potential need to centralize care for this complex procedure.