Why the study?
The utility of routine balloon predilation in TAVR with self-expanding valves is not established, and clinical outcomes at 30 days and 1 year with a no balloon predilation strategy have not been systematically described.
Does routine balloon predilation improve procedural and clinical outcomes in patients undergoing TAVR with self-expanding valves?
Population
564 patients who underwent TAVR with self-expanding valves
Comparison
Predilation vs no predilation
Design
Observational cohort study
Follow-up
1 year
Key result
Balloon predilation in TAVR was associated with a lower need for postdilation (30.2% vs 39.0%) but higher permanent pacemaker implantation (25.1% vs 15.6%; aOR 3.086) compared to no predilation.
Authors
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Predilation may raise pacemaker risk without PVL benefit; leaves open whether routine use improves self-expanding TAVR outcomes.
Cohort (n=564)
Does routine balloon predilation improve procedural and clinical outcomes in patients undergoing TAVR with self-expanding valves?
Odds Ratio: 0.741 (95% CI 0.493–1.114)
Absolute Event Rate: 30.2% vs 39%
Balloon predilation during TAVR with self-expanding valves is associated with an increased risk of permanent pacemaker implantation without significant differences in paravalvular leak, stroke, or death.
Rehman et al. (2018) conducted a cohort in Transcatheter aortic valve replacement (TAVR) (n=564). Balloon predilation vs. No predilation was evaluated on Need for postdilation (aOR 0.741, 95% CI 0.493-1.114). Balloon predilation in TAVR was associated with a lower need for postdilation (30.2% vs 39.0%) but higher permanent pacemaker implantation (25.1% vs 15.6%; aOR 3.086) compared to no predilation.
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