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Title: Balloon Aortic Valvuloplasty in the Transcatheter Valve Era: Single Centre Indications and Early Safety Data in a High Risk Population
Authors: Ford, Tom ;Nguyen, K.;Brassil, J.;Kushwaha, V.;Friedman, D.;Allan, R.;Pitney, M.;Jepson, N.
Affliation: Central Coast Local Health District
Gosford Hospital
Issue Date: May-2018
Source: 27(5):595-600
Journal title: Heart Lung and Circulation
Heart, Lung & Circulation
Department: Cardiology
Abstract: BACKGROUND: The introduction of transcatheter aortic valve implantation (TAVI) has generated a renewed interest in the techniques available to treat high-risk patients with severe aortic stenosis (AS). We report our single centre experience with balloon aortic valvuloplasty (BAV) focussing on indications, procedural success and 30-day outcomes. METHODS: We retrospectively reviewed all patients that underwent BAV procedures at our institution between August 2012 and August 2014. Procedural success and complications were adjudicated according to VARC-2 criteria. RESULTS: Fifty-one consecutive adult patients with severe symptomatic AS underwent a total of 55 BAV procedures. The patients had a mean age of 88+/-5.7 years and all had extensive comorbidities with a high surgical risk (mean logistic EuroSCORE of 25.22%+/-14.5%). Indications for BAV included palliation of symptoms n=42 (76%); bridge to definitive valve replacement (n=6, 11%); and evaluation of response (n=6, 11%). The procedure was completed in all patients with no intraprocedural deaths (within 24hours) and low 30-day mortality at 3.9% (n=2). Minor vascular complications occurred in 11.8% (n=6), whilst permanent pacemaker implantation was required in 5.8% (n=3). There were no cases of myocardial infarction, stroke, tamponade, severe aortic regurgitation or major vascular complications during 30-day follow-up. CONCLUSIONS: Balloon aortic valvuloplasty may be performed safely and effectively with high procedural success and low 30-day complications, even in a very high-risk and elderly cohort of patients in whom the role of TAVI is uncertain or inappropriate.
DOI: 10.1016/j.hlc.2017.05.128
ISSN: 1443-9506
Publicaton type: Journal Article
Keywords: Cardiology
Cardiovascular Disease
Heart Disease
Appears in Collections:Cardiology

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