September 28, 2012Catheterization and Cardiovascular Interventions
Balloon aortic valvuloplasty for severe aortic stenosis as a bridge to transcatheter/surgical aortic valve replacement
Key result
Balloon aortic valvuloplasty as a bridge to valve replacement was associated with lower mortality compared to BAV alone (22.3% vs 55.2%, P<0.001).
Why the study?
Does balloon aortic valvuloplasty as a bridge to T/SAVR improve survival compared to BAV alone in high-risk patients with severe aortic stenosis?
Population
472 high-risk patients with severe aortic stenosis
Comparison
Balloon aortic valvuloplasty as a bridge to… vs Balloon aortic valvuloplasty as a standalone…
Design
Cohort
Follow-up
Median 183 days for BAV alone, 378 days for BAV as a bridge
Authors
Discussion
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Implication
Supports BAV bridging in high-risk severe AS; leaves open need for randomized confirmation of survival benefit.
Key Points
- This research evaluates the success and complication rates of balloon aortic valvuloplasty versus its use as a bridge to transcatheter or surgical aortic valve replacement.
- Cohort study of 472 patients with 538 BAV procedures performed.
- Patients divided into two groups: BAV alone (n = 387) and BAV as a bridge (n = 85) to TAVR (n = 65) or surgery (n = 20).
- Clinical and hemodynamic data assessed during follow-up, median 183-378 days.
- Mortality rate in BAV alone group was 55.2% (n = 214) compared to 22.3% (n = 19) in BAV as a bridge, P < 0.001.
- No significant differences in age, STS score, EuroSCORE, and comorbidities between the groups.
- Mean increase in aortic valve area was 0.39 cm² in BAV alone vs. 0.42 cm² in BAV as a bridge, P = 0.33.
Study Design
Type
Cohort (n=472)
Structured PICO
Does balloon aortic valvuloplasty as a bridge to T/SAVR improve survival compared to BAV alone in high-risk patients with severe aortic stenosis?
P
Population
472 patients with severe aortic stenosis undergoing balloon aortic valvuloplasty either as standalone therapy or as a bridge to transcatheter or surgical aortic valve replacement.
E
Exposure
Balloon aortic valvuloplasty (BAV) as a bridge to transcatheter or surgical aortic valve replacement (T/SAVR)
C
Comparator
Balloon aortic valvuloplasty (BAV) as a standalone therapy
O
Outcome
Follow-up mortalityhard clinical
Main Result
Absolute Event Rate: 22.3% vs 55.2%
p-value: p=< 0.001
In high-risk patients with severe aortic stenosis, balloon aortic valvuloplasty serves as an effective bridge to definitive valve replacement, associated with significantly lower mortality than BAV alone.
Cite This Study
Ben‐Dor et al. (2012) conducted a cohort in severe aortic stenosis (n=472). Balloon aortic valvuloplasty as a bridge to T/SAVR vs. Balloon aortic valvuloplasty alone was evaluated on Mortality (p=< 0.001). Balloon aortic valvuloplasty as a bridge to valve replacement was associated with lower mortality compared to BAV alone (22.3% vs 55.2%, P<0.001).