Balloon aortic valvuloplasty for severe aortic stenosis as a bridge to transcatheter/surgical aortic valve replacement. Issue 4 (8th November 2012)

• Record Type: Journal Article
• Authors: Ben‐Dor, Itsik; Maluenda, Gabriel; Dvir, Danny; Barbash, Israel M.; Okubagzi, Petros; Torguson, Rebecca; Lindsay, Joseph; Satler, Lowell F.; Pichard, Augusto D.; Waksman, Ron
• Is Part Of: Catheterization and cardiovascular interventions. Volume 82:Issue 4(2013:Oct. 01)
• Page Start: 632
• Page End: 637
• Publication Date: 2012-11-08
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.24682
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <p> <bold>Objectives</bold>: This study aimed to determine success‐ and complication rates after balloon aortic valvuloplasty (BAV) and the outcome of BAV as a standalone therapy versus BAV as a bridge to transcatheter/surgical aortic valve replacement (T/SAVR). <bold>Background</bold>: The introduction of transcatheter aortic valve replacement (TAVR) has led to a revival in BAV as treatment for patients with severe aortic stenosis. <bold>Methods</bold>: A cohort of 472 patients underwent 538 BAV procedures. The cohort was divided into two groups: BAV alone 387 (81.9%) and BAV as a bridge 85 (18.1%) to (<italic>n</italic> = 65, TAVR; <italic>n</italic> = 20, surgery). Clinical, hemodynamic, and follow‐up mortality data were collected. <bold>Results</bold>: There was no significant difference between the two groups in mean age (81.7 ± 8.3 vs. 83.2 ± 10.9 years, <italic>P</italic> = 0.18), society of thoracic surgeons score (13.1 ± 6.2 and 12.4 ± 6.4, <italic>P</italic> = 0.4), logistic EuroSCORE (45.4 ± 22.3 vs. 46.9 ± 21.8, <italic>P</italic> = 0.43), and other comorbidities. The mean increase in aortic valve area was 0.39 ± 0.25 in the BAV alone group and 0.42 ± 0.26 in the BAV as a bridge group, <italic>P</italic> = 0.33. The decrease in mean gradient was 24.1 ± 13.1 in the BAV alone group vs. 27.1 ± 13.8 in the BAV as a bridge group, <italic>P</italic> = 0.06. During a median follow up of 183 days [54–409], the mortality rate was 55.2% (<italic>n</italic> = 214) in the BAV alone group vs. 22.3% (<italic>n</italic> = 19) in the BAV as a bridge group during a median follow‐up of 378 days [177–690], <italic>P</italic> < 0.001. <bold>Conclusion</bold>: In high‐risk patients with aortic stenosis and temporary contraindications to SAVR/TAVR, BAV may be used as a bridge to intervention with good mid‐term outcomes. © 2012 Wiley Periodicals, Inc.</p> </abstract>