July 8, 2010Journal of Interventional Cardiology
Lessons Learned from Balloon Aortic Valvuloplasty Experience from the Pre‐transcatheter Aortic Valve Implantation Era
Key result
Among patients undergoing balloon aortic valvuloplasty for severe aortic stenosis, subsequent aortic valve replacement was associated with higher 1-year survival compared to no replacement (78% vs 44%; P=0.024).
Why the study?
Does subsequent aortic valve replacement improve survival in high-risk patients with severe symptomatic aortic stenosis who underwent balloon aortic valvuloplasty?
Population
90 consecutive patients with severe symptomatic aortic stenosis with no immediate surgical option…
Comparison
Balloon aortic valvuloplasty with subsequent… vs Balloon aortic valvuloplasty without subsequent…
Design
Cohort
Follow-up
Average 55 ± 57 months and 16 ± 23 months
Authors
Discussion
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Implication
Supports AVR after BAV for higher 1-year survival in severe AS; leaves open selection bias versus benefit, needing RCTs.
Study Design
Type
Cohort (n=90)
Structured PICO
Does subsequent aortic valve replacement improve survival in high-risk patients with severe symptomatic aortic stenosis who underwent balloon aortic valvuloplasty?
P
Population
90 consecutive patients with severe symptomatic aortic stenosis and no immediate surgical option who underwent balloon aortic valvuloplasty between 1990 and 2005.
E
Exposure
Balloon aortic valvuloplasty (BAV) with subsequent aortic valve replacement (AVR)
C
Comparator
Balloon aortic valvuloplasty (BAV) without subsequent aortic valve replacement (AVR)
O
Outcome
Survival rates at 6 months and 1 yearhard clinical
Main Result
Absolute Event Rate: 78% vs 44%
p-value: p=0.024
Balloon aortic valvuloplasty can serve as an effective bridge to aortic valve replacement in high-risk patients with severe symptomatic aortic stenosis, significantly improving 1-year survival when AVR is achieved.
Cite This Study
Kapadia et al. (2010) conducted a cohort in Severe symptomatic aortic stenosis (n=90). Aortic valve replacement (AVR) post-balloon aortic valvuloplasty vs. No aortic valve replacement was evaluated on 1-year survival rate (p=0.024). Among patients undergoing balloon aortic valvuloplasty for severe aortic stenosis, subsequent aortic valve replacement was associated with higher 1-year survival compared to no replacement (78% vs 44%; P=0.024).