January 1, 2018BioMed Research InternationalOpen Access

Aortic Valve Predilatation with a Small Balloon, without Rapid Pacing, prior to Transfemoral Transcatheter Aortic Valve Replacement

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: severe aortic stenosis (n=50). Intervention: Aortic valve predilatation with a small, nonocclusive balloon without rapid pacing. Primary outcome: Procedural success (crossing the AV and prosthesis implantation).

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Key result

Aortic valve predilatation with a small, nonocclusive balloon without rapid pacing during TAVR achieved 100% procedural success and 0% mortality at 30 days.

Why the study?

Does aortic valve predilatation with a small, nonocclusive balloon without rapid pacing allow for safe and feasible transfemoral TAVR in patients with severe aortic stenosis?

Study Design

Type

Cohort (n=50)

Structured PICO

Does aortic valve predilatation with a small, nonocclusive balloon without rapid pacing allow for safe and feasible transfemoral TAVR in patients with severe aortic stenosis?

Population

50 consecutive patients (mean age 81) with severe aortic stenosis undergoing transfemoral TAVR, evaluated for procedural success and 30-day clinical outcomes.

Exposure

Aortic valve predilatation (AVPD) with a small, nonocclusive balloon (12 × 60 or 14 × 60 mm) without rapid pacing prior to transfemoral TAVR with the Edwards Sapien 3 heart valve.

Outcome

Feasibility (successful crossing of the AV and prosthesis implantation) and clinical outcomes (postprocedural mean AV gradient, aortic regurgitation, periprocedural stroke, and 30-day mortality).safety

Aortic valve predilatation using a small, nonocclusive balloon without rapid pacing is a feasible and safe alternative to traditional balloon aortic valvuloplasty during transfemoral TAVR.

Limitations

Whether the technique translates into fewer periprocedural complications needs to be assessed in future studies.
Whether the technique translates into fewer periprocedural complications needs to be assessed in future studies

Discussion

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Implication

Supports feasibility of small-balloon AVPD without pacing in TAVR; leaves open whether this improves outcomes versus standard techniques.

Cite This Study

Shivaraju et al. (2018) conducted a cohort in severe aortic stenosis (n=50). Aortic valve predilatation with a small, nonocclusive balloon without rapid pacing was evaluated on Procedural success (crossing the AV and prosthesis implantation). Aortic valve predilatation with a small, nonocclusive balloon without rapid pacing during TAVR achieved 100% procedural success and 0% mortality at 30 days.

synapsesocial.com/papers/6a35da46a4e90ae4d3ef5025 https://doi.org/10.1155/2018/1080597

Topics

TAVR in low-risk patients Transcatheter aortic valve replacement

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Aortic Valve Predilatation with a Small Balloon, without Rapid Pacing, prior to Transfemoral Transcatheter Aortic Valve Replacement

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Aortic Valve Predilatation with a Small Balloon, without Rapid Pacing, prior to Transfemoral Transcatheter Aortic Valve Replacement

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider