REPEAT

• Research type

  Research Study

• Full title

  REpeat Intervention for Deteriorated Surgical BioProsthEtic AorTic Valves (REPEAT): A Multicentre Randomised Trial Comparing Redo Surgical Aortic Valve Replacement to Valve-in-Valve Transcatheter Aortic Valve Replacement

• IRAS ID

  359609

• Contact name

  Enoch Akowuah

• Contact email

  enoch.akowuah@nhs.net

• Sponsor organisation

  South Tees Hospitals NHS Foundation Trust

• Clinicaltrials.gov Identifier

  NCT07462624

• Clinicaltrials.gov Identifier

  DRKS00034170, German Clinical Trials Register

• Duration of Study in the UK

  7 years, 5 months, 31 days

• Research summary

  Aortic Valve Replacement (AVR) surgery is the best way to treat people with a narrowing or leaking aortic heart valve. Biological (tissue) heart valves are often used, but in the years after surgery these can fail. If they fail (known as structural valve deterioration, SVD), they can be replaced in one of two ways: traditionally, it has been with repeat heart surgery (called re-do surgical aortic valve replacement - rSAVR), more recently (the last 10-15 years) a less invasive technique, called a valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) has become an established alternative.
  rSAVR involves opening up the chest to access the heart and cardiac bypass, resulting in usually a longer recovery time and other complications as a consequence of major surgery. ViV-TAVR involves inserting a catheter into an artery (usually in the groin area), which is then used to deliver a new valve into place over the old valve; as this is much less invasive, recovery times are usually faster.
  Both procedures are accepted methods to treat failed heart valves. rSAVR has been preferred for younger patients with low surgical risk, whilst ViV-TAVR offers improved safety in higher risk patients (e.g., older people or people with other health conditions). ViV-TAVR has better short-term clinical outcomes, but the long-term outcomes are unclear and the performance of the valve after ViV-TAVR may be worse than after rSAVR.
  There is no current agreement on how to treat low-to-intermediate risk patients needing a replacement aortic valve and clinical decision-making isn’t based on good data. With an increasing number of people in their 60s needing a replacement valve, this research will help address the lack of evidence and aim to provide guidance to ensure the best treatment pathway in the future.
  

• REC name

  Wales REC 3

• REC reference

  26/WA/0131

• Date of REC Opinion

  20 May 2026

• REC opinion

  Favourable Opinion