October 1, 2011EuroIntervention
The role of percutaneous balloon aortic valvuloplasty as a bridge for transcatheter aortic valve implantation
Key result
Percutaneous balloon aortic valvuloplasty as a bridge to TAVI had a 6.4% periprocedural adverse event rate, and 46% of bridge patients subsequently became eligible for TAVI.
Why the study?
Does percutaneous balloon aortic valvuloplasty serve as an effective bridge to TAVI in patients with severe aortic stenosis who are not immediately eligible?
Population
210 consecutive patients with severe aortic stenosis referred for percutaneous balloon aortic valvuloplasty…
Design
Cohort
Follow-up
around one month after BAV; 30-day post-TAVI
Authors
Discussion
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Member takes
Implication
Supports BAV bridging in selected inoperable aortic stenosis; observational data leaves open need for randomized confirmation of eligibility gains.
Key Points
- Evaluate the effectiveness of balloon aortic valvuloplasty (BAV) as a bridge to transcatheter aortic valve implantation (TAVI) in inoperable patients with severe aortic stenosis.
- Analyzed data from 210 patients referred for BAV, categorized into three groups based on TAVI eligibility.
- Conducted outpatient clinic visits and echocardiography one month post-BAV to determine further treatment options.
- Documented periprocedural adverse events during and after the BAV procedure.
- 46% of patients initially ineligible for TAVI became eligible post-BAV, while 28% became eligible for cardiac surgery.
- The incidence of periprocedural adverse events was 6.4%, including a 5.1% mortality rate and 1.3% minor stroke.
- Patients who underwent TAVI after a bridge BAV had a 94% survival rate at 30 days.
Study Design
Type
Observational (n=210)
Multicenter
No
Structured PICO
Does percutaneous balloon aortic valvuloplasty serve as an effective bridge to TAVI in patients with severe aortic stenosis who are not immediately eligible?
P
Population
210 consecutive patients with severe aortic stenosis referred for percutaneous balloon aortic valvuloplasty, with a mean age of 81 years.
E
Exposure
Percutaneous balloon aortic valvuloplasty (BAV) as a bridge to transcatheter aortic valve implantation (TAVI)
O
Outcome
Periprocedural adverse events (death, minor stroke) and subsequent eligibility for TAVI or cardiac surgery evaluated around one month after BAV
Balloon aortic valvuloplasty is a safe and effective strategy to bridge selected high-risk patients with severe aortic stenosis to TAVI or surgical valve replacement.
Cite This Study
Saia et al. (2011) conducted an observational in Severe aortic stenosis (n=210). Percutaneous balloon aortic valvuloplasty was evaluated on Periprocedural adverse events. Percutaneous balloon aortic valvuloplasty as a bridge to TAVI had a 6.4% periprocedural adverse event rate, and 46% of bridge patients subsequently became eligible for TAVI.