Key result
Contemporary balloon aortic valvuloplasty remains useful in selected patients with symptomatic severe aortic stenosis as a bridge to valve replacement, triage strategy, or palliative measure.
Why the study?
Although BAV does not improve long-term prognosis, its contemporary role has evolved with changing clinical indications, technical innovations, and use in complex patient subgroups.
Contemporary balloon aortic valvuloplasty remains useful in selected patients with severe aortic stenosis as a bridge to definitive therapy, a triage strategy, or a palliative measure, with technical innovations decreasing complications.
Supports selective BAV use as bridge or palliation in severe AS; leaves open need for prospective trials.
Even if un to improve long-term prognosis, balloon aortic valvuloplasty (BAV) may be useful in selected patients with symptomatic severe aortic stenosis either as a bridge to surgical or transcatheter valve replacement (aortic valve replacement [AVR] or transcatheter aortic valve implantation [TAVI]) or as a triage strategy for patients with uncertain indications. International guidelines recommend BAV as: a "bridge" to AVR/TAVI, a "trial" in patients with undetermined symptoms, or a "bridge-to-decision" in case of comorbidities. However, in clinical practice, BAV is also used as a palliative measure to improve hemodynamics and quality of life in many patients who are excluded from AVR/TAVI. Finally, BAV is often performed during TAVI to facilitate prosthesis delivery, optimize frame expansion, or for bioprosthetic valve fracture in selected valve-in-valve procedures. Technical innovations, which allow for a mini-invasive approach via transradial access and pacing delivered through the wire, have led to a decrease in complications over time. This review focuses on contemporary BAV with a specific emphasis on new indications, innovative techniques, and specific complex patient subgroups.
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Dall’Ara et al. (2020) conducted a review in Symptomatic severe aortic stenosis. Balloon aortic valvuloplasty was evaluated. Contemporary balloon aortic valvuloplasty remains useful in selected patients with symptomatic severe aortic stenosis as a bridge to valve replacement, triage strategy, or palliative measure.
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