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March 27, 2014European Journal of Cardio-Thoracic SurgeryOpen Access

First experience without pre-ballooning in transapical aortic valve implantation: a propensity score-matched analysis†

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Key result

Direct transapical aortic valve implantation without pre-ballooning showed no significant differences in primary endpoints compared to pre-ballooning, and was associated with lower fluoroscopy time.

Why the study?

Does direct transapical aortic valve implantation without pre-ballooning improve procedural and clinical outcomes in high-risk elderly patients compared to implantation with pre-ballooning?

Population

128 high-risk elderly patients undergoing transapical aortic valve implantation using Edwards SAPIEN XT valves

Comparison

Direct transapical aortic valve implantation… vs Transapical aortic valve implantation with prior…

Design

Cohort

Follow-up

30 days

Authors

JKJörg KempfertAMAlexander MeyerALArnaud Van Linden

Discussion

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Member takes

Overview

May support omitting pre-ballooning to reduce fluoroscopy time; leaves open safety confirmation in randomized trials.

Study Design

Type

Cohort (n=128)

Structured PICO

Does direct transapical aortic valve implantation without pre-ballooning improve procedural and clinical outcomes in high-risk elderly patients compared to implantation with pre-ballooning?

P
Population
128 high-risk elderly patients undergoing transapical aortic valve implantation.
E
Exposure
Direct transapical aortic valve implantation (TA-AVI) without prior balloon valvuloplasty (BAV)
C
Comparator
Transapical aortic valve implantation (TA-AVI) with prior balloon valvuloplasty (BAV)
O
Outcome
Aortic valve incompetence ≥2+, Pmean postimplantation, major stroke, transient ischaemic attack (TIA), requirement for post-dilatation and necessity for new pacemaker implantationsafety

Direct transapical aortic valve implantation without pre-ballooning is feasible, safe, and may reduce fluoroscopy time and neurological events compared to standard pre-ballooning.

Cite This Study

Kempfert et al. (2014) conducted a cohort in Aortic valve disease (n=128). Direct transapical aortic valve implantation without pre-ballooning vs. Transapical aortic valve implantation with pre-ballooning was evaluated on Aortic valve incompetence ≥2+, Pmean postimplantation, major stroke, transient ischaemic attack (TIA), requirement for post-dilatation and necessity for new pacemaker implantation. Direct transapical aortic valve implantation without pre-ballooning showed no significant differences in primary endpoints compared to pre-ballooning, and was associated with lower fluoroscopy time.

synapsesocial.com/papers/6a97e005a2c7923eae15e2aahttps://doi.org/10.1093/ejcts/ezu097
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Transapical minimally invasive aortic valve implantation; the initial 50 patients☆2008 · 258 citations
  2. 2Transapical Minimally Invasive Aortic Valve Implantation2007 · 620 citations
  3. 3Transcatheter aortic valve implantation without balloon predilation: A single‐center pilot experience2013 · 24 citations
  4. 4Percutaneous Transcatheter Implantation of an Aortic Valve Prosthesis for Calcific Aortic Stenosis2002 · 3,196 citations
  5. 5Do observational studies using propensity score methods agree with randomized trials? A systematic comparison of studies on acute coronary syndromes2012 · 204 citations