Active Heart, Stroke & Blood NIHR-supported project Lungs & Breathing

REdo Transcatheter Aortic VALVE Implantation for the management of Transcatheter Aortic Valve Failure: REVALVE

Funder NIHR (part of DHSC)
Recipient organisation NIHR Oxford Biomedical Research Centre
NIHR support Recorded as supported by this research centre
Period Mar 2025 — Oct 2032

In plain English

AI plain-English summary

A failing TAVI valve is being replaced by slotting a second valve inside it, without open-heart surgery. This matters because TAVI has become the most common way to replace faulty aortic heart valves, but the tissue valves eventually degenerate. When that happens, doctors have little evidence to guide them on whether a second TAVI procedure works, how to do it safely, or which patients will benefit. The study will track short- and long-term outcomes for patients undergoing Redo TAVI, and also follow those who are not suitable for the procedure and instead receive surgery or medication. If the research succeeds, it will give cardiologists and surgeons the first robust data on how well Redo TAVI performs in practice. That could help standardise the procedure, identify which patients are good candidates, and improve decision-making for the growing number of people whose TAVI valves will fail in the coming years. It will also clarify how many patients with valve failure are not candidates for Redo TAVI, and what happens to them with alternative treatments.

View original technical description
Transcatheter aortic valve implantation (TAVI) is a key-hole technique to replace a faulty (narrowed and/or leaking) aortic heart valve. The replacement aortic valve is delivered to the heart through tubes inserted in a main artery (usually the artery in the groin). Over the past 15 years TAVI has rapidly grown and has taken over from open-heart surgery (surgical aortic valve replacement (SAVR)) to become the most commonly used technique for aortic heart valve replacement. Although TAVI is a safe and effective treatment for a faulty aortic heart valve, the new TAVI valve will not last forever. Because it is a tissue valve (made from the lining of a cow or pig heart), the valve will fail after a period of time as the tissue degenerates. When the TAVI valve fails, a viable treatment option is to perform a Redo TAVI procedure, implanting a second TAVI valve inside the first failing valve. However, very little is known about the outcomes of Redo TAVI, or about the best way to do such a procedure. The purpose of this study is to carefully evaluate patients being treated by Redo TAVI in order to document the short-term and long-term outcomes of the procedure and in order to obtain information about which factors predict those outcomes. The study will also collect data on patients who present with failure of a TAVI valve but are not suitable for Redo TAVI, and instead are treated either by open-heart surgery or by medication. These additional parts of the study will provide an understanding of the proportion of patients presenting with TAVI valve failure who are not suitable for Redo TAVI, and of the outcomes with alternative treatment strategies.

Researchers

Rajesh Kharbanda (Principal Investigator)

Related Research

Grants with similar aims, by meaning.

The United Kingdom Transcatheter Aortic Valve Implantation (UK TAVI) Trial. A multi-centre randomised controlled trial to assess the clinical effectiveness and cost-utility of TAVI, compared with conventional surgical aortic valve replacement, in patients with severe symptomatic aortic stenosis at intermediate or high operative risk.
The United Kingdom Transcatheter Aortic Valve Implantation Trial. A multicentre randomised controlled trial to assess the clinical effectiveness and cost-utility of TAVI, compared with conventional surgical aortic valve replacement, in patients with severe symptomatic aortic stenosis at intermediate or high operative risk.
A Prospective, Randomized, Controlled, Multi-Center Study to Evaluate the Safety and Efficacy of Transcatheter Aortic Valve Implantation in Female Patients who have Severe Symptomatic Aortic Stenosis Requiring Aortic Valve Replacement
The United Kingdom Transcatheter Aortic Valve Implantation (UK TAVI) Trial. A multicentre randomised controlled trial to assess the clinical effectiveness and cost-utility of TAVI, compared with conventional surgical aortic valve replacement, in patients with severe symptomatic aortic stenosis at intermediate or high operative risk.
The United Kingdom Transcatheter Aortic Valve Implantation (UK TAVI) Trial. A multi-centre randomised controlled trial to assess the clinical effectiveness and cost-utility of TAVI, compared with conventional surgical aortic valve replacement, in patients with severe symptomatic aortic stenosis at intermediate or high operative risk

Original classification

Cardiovascular Medicine

Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.