A novel device for antegrade percutaneous balloon aortic valvuloplasty: Feasibility of the looped inoue balloon technique in swine model

OBJECTIVES: The study aimed to assess the feasibility of a novel device and technique for antegrade percutaneous balloon aortic valvuloplasty (BAV) in a swine model. BACKGROUND: BAV is currently being applied more frequently compared to the past with the advent of transcatheter aortic valve replacement. Although the antegrade BAV approach offers several advantages over the retrograde approach, the antegrade approach is technically more complicated and demanding. METHODS: We developed a novel balloon catheter and a technique to simplify the antegrade BAV. The balloon catheter was designed to make a loop in left atrium by inserting two different sized stylets. The balloon catheter was easily dropped into the left ventricle via the mitral valve while maintaining the loop. The balloon catheter was advanced to the ascending aorta by holding the two stylets. Then, the balloon was inflated. We named the technique as the looped Inoue balloon technique. The feasibility of the looped Inoue balloon technique was assessed in a healthy swine with a body weight of 40 kg by four independent operators. Every operator conducted the procedure twice. RESULTS: The procedural success rate was 100% in all operators. The average procedure time was 170 ± 35 sec. No procedure related complications were noted. CONCLUSIONS: The study results indicate that the antegrade BAV using the looped Inoue balloon technique is feasible and may simplify the antegrade approach.