Key result
Percutaneous balloon aortic valvuloplasty may serve as a bridge to TAVI in patients with hemodynamic instability, low-flow low-gradient aortic stenosis, or needing major noncardiac surgery.
Why the study?
Does percutaneous balloon aortic valvuloplasty improve clinical status or reduce operative risk in high-surgical risk patients with aortic stenosis who cannot undergo TAVI as first-line treatment?
Does percutaneous balloon aortic valvuloplasty improve clinical status or reduce operative risk in high-surgical risk patients with aortic stenosis who cannot undergo TAVI as first-line treatment?
Answers are grounded in this paper and cite their sources.
In the TAVI era, percutaneous balloon aortic valvuloplasty remains a valuable bridging strategy for specific high-risk patient subsets who are not immediate candidates for TAVI.
Until recently, percutaneous balloon aortic valvuloplasty (PBAV) had limited indications as a bridge to surgical aortic valve replacement in elderly patients with depressed left ventricular function. Since the advent of transcatheter aortic valve implantation (TAVI), most high-surgical risk patients are currently referred for TAVI, allowing for a new role for PBAV in three subsets of patients who cannot perform TAVI as first-line treatment: presence of hemodynamic instability-PBAV may improve the clinical status and allow to perform TAVI; presence of a low-flow low-gradient aortic stenosis-PBAV may reveal who benefits from a stable decrease in aortic gradient; and need for major noncardiac surgery-PBAV may reduce the operative risk and allow subsequent definition of the indication to TAVI.
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Petronio et al. (2014) conducted a review in Aortic stenosis. Percutaneous balloon aortic valvuloplasty (PBAV) was evaluated. Percutaneous balloon aortic valvuloplasty may serve as a bridge to TAVI in patients with hemodynamic instability, low-flow low-gradient aortic stenosis, or needing major noncardiac surgery.
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