• Valve-in-valve (VIV) transcatheter aortic valve replacement (TAVR) has become an attractive alternative to conventional redo surgical aortic valve replacement (SAVR) for patients with structural valve degeneration (SVD).
• VIV TAVR is associated with a nearly twofold lower odds of early mortality compared with redo-SAVR in patients with SVD.
• Adequately powered randomized studies examining the optimal intervention in patients with SVD specifically of lower surgical risk, are warranted to guide clinical decision-making.

中文翻译：

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瓣中瓣经导管主动脉瓣置换术与重新手术主动脉瓣置换术：随机对照试验的呼吁

• 瓣中瓣 (VIV) 经导管主动脉瓣置换术 (TAVR) 已成为传统重做主动脉瓣置换术 (SAVR) 的一种有吸引力的替代方案，适用于结构性瓣膜变性 (SVD) 患者。
• 在 SVD 患者中，与 redo-SAVR 相比，VIV TAVR 的早期死亡率降低了近两倍。
• 有必要对SVD 患者的最佳干预措施进行充分有力的随机研究，特别是手术风险较低的患者，以指导临床决策。