May 1, 2011EuroIntervention
Reappraisal of percutaneous aortic balloon valvuloplasty as a preliminary treatment strategy in the transcatheter aortic valve implantation era
Key result
In high-risk patients with aortic stenosis, bridge PABV yielded 1- and 2-year survival rates of 94% and 85%, with no significant difference compared to primary TAVI or AVR (p=0.08).
Why the study?
Does percutaneous aortic balloon valvuloplasty as a bridge to intervention improve survival in high-risk patients referred for TAVI?
Population
253 high-risk patients referred for transcatheter aortic valve implantation, mean age 82 ± 8 years, logistic…
Comparison
Percutaneous aortic balloon valvuloplasty as a… vs Primary TAVI or AVR, and medical therapy alone
Design
Cohort
Follow-up
2 years
Authors
Discussion
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Implication
PABV bridging may be feasible in select TAVI-ineligible patients; leaves open its clinical role pending prospective data.
Key Points
- This study evaluates the effectiveness of percutaneous aortic balloon valvuloplasty (PABV) as a temporary solution in patients unsuitable for transcatheter aortic valve implantation (TAVI).
- Study population included 253 patients referred for TAVI, with 41 undergoing PABV as a bridge to intervention.
- Survival rates were assessed post-PABV, comparing outcomes with primary TAVI/AVR and medical therapy.
- Patients' median age was 82 years, and high-risk assessments were conducted using logistic EuroSCORE and STS score.
- One and two year survival rates after bridge PABV were 94% and 85%, respectively.
- Survival rates after PABV alone were significantly lower at 33% and 6%.
- No PABV-related deaths were reported, indicating safety of the procedure.
Study Design
Type
Cohort (n=253)
Structured PICO
Does percutaneous aortic balloon valvuloplasty as a bridge to intervention improve survival in high-risk patients referred for TAVI?
P
Population
253 high-risk patients (mean age 82 years) with aortic stenosis referred for TAVI, evaluated for outcomes following percutaneous aortic balloon valvuloplasty as a bridge to intervention.
E
Exposure
Percutaneous aortic balloon valvuloplasty (PABV) as a bridge to intervention (TAVI or AVR)
C
Comparator
Primary TAVI or AVR, and medical therapy alone
O
Outcome
Survival rates at 1 and 2 yearshard clinical
Main Result
p-value: p=0.08
PABV is a viable bridge to definitive TAVI or AVR in high-risk patients with temporary contraindications, achieving mid-term survival comparable to primary intervention.
Cite This Study
Tissot et al. (2011) conducted a cohort in Aortic stenosis (n=253). Percutaneous aortic balloon valvuloplasty (PABV) vs. Primary TAVI/AVR or medical therapy was evaluated on Survival (p=0.08). In high-risk patients with aortic stenosis, bridge PABV yielded 1- and 2-year survival rates of 94% and 85%, with no significant difference compared to primary TAVI or AVR (p=0.08).