Aim. Aortic valve replacement (AVR) in patients with prior cardiac surgery might be challenging. Transcatheter aortic valve\nreplacement (TAVR) offers a promising alternative in such patients. We therefore aimed at comparing the outcomes of patients\nwith aortic valve diseases undergoing TAVR versus those undergoing surgical AVR (SAVR) after previous cardiac surgery.\nMethods and Results. MEDLINE, EMBASE, and the Cochrane Central Register were searched. Seven relevant studies were\nidentified, published between 01/2011 and 12/2015, enrolling a total of 1148 patients with prior cardiac surgery (97.6% prior\nCABG): 49.2% underwent TAVR, whereas 50.8% underwent SAVR. Incidence of stroke (3.8 versus 7.9%, p 0.04) and major\nbleeding (8.3 versus 15.3%, p 0.04) was significantly lower in the TAVR group. Incidence of mild/severe paravalvular leakage\n(14.4/10.9 versus 0%, p < 0.0001) and pacemaker implantation (11.3 versus 3.9%, p 0.01) was significantly higher in the TAVR\ngroup. There were no significant differences in the incidence of acute kidney injury (9.7 versus 8.7%, p 0.99), major adverse\ncardiovascular events (8.7 versus 12.3%, p 0.21), 30-day mortality (5.1 versus 5.5%, p 0.7), or 1-year mortality (11.6 versus\n11.8%, p 0.97) between the TAVR and SAVR group. Conclusions. TAVR as a redo procedure offers a safe alternative for patients\npresenting with aortic valve diseases after previous cardiac surgery especially those with prior CABG.
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