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June 1, 2017EuroIntervention

Omission of predilation in balloon-expandable transcatheter aortic valve implantation: retrospective analysis in a large-volume centre

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Key result

Omitting predilation in balloon-expandable TAVI is linked to ~57% lower 30-day mortality and shorter procedures.

  • P=0.03
  • n=680

Why the study?

The effect of omitting predilation on feasibility, procedural results, and safety in balloon-expandable TAVI was not well established.

Does the omission of predilation improve procedural outcomes and safety in patients undergoing balloon-expandable TAVI?

Population

680 patients scheduled for balloon-expandable TAVI prosthesis

Comparison

Balloon-expandable TAVI without predilation vs with predilation

Design

Retrospective analysis in a large-volume centre

Follow-up

30 days

Authors

KHKarsten HammWRWilko ReentsMZMichael Zacher

Discussion

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Member takes

Overview

May favor omitting predilation in balloon-expandable TAVI; leaves open confirmation in randomized trials.

Study Design

Type

Cohort (n=680)

Multicenter

No

Structured PICO

Does the omission of predilation improve procedural outcomes and safety in patients undergoing balloon-expandable TAVI?

P
Population
680 patients scheduled for a balloon-expandable TAVI prosthesis evaluated retrospectively to compare outcomes with or without predilation.
E
Exposure
Balloon-expandable TAVI without predilation (omission of prior valvuloplasty)
C
Comparator
Balloon-expandable TAVI with predilation
O
Outcome
Feasibility, procedural results and safety (including VARC-2 device success, clinical efficacy, early safety, and 30-day mortality)composite

Main Result

Absolute Event Rate: 2.9% vs 6.8%

p-value: p=0.03

Omitting predilation in balloon-expandable TAVI is feasible and associated with shorter procedure times, less contrast use, and lower 30-day mortality compared to routine predilation.

Cite This Study

Hamm et al. (2017) conducted a cohort in Scheduled for balloon-expandable TAVI (n=680). Omission of predilation vs. TAVI with predilation (prior valvuloplasty) was evaluated on 30-day all-cause mortality (p=0.03). Omission of predilation during balloon-expandable TAVI was associated with lower 30-day all-cause mortality (2.9% vs 6.8%, p=0.03) and shorter procedure times compared to prior valvuloplasty.

synapsesocial.com/papers/6aacbe61356d077555b0dabbhttps://doi.org/10.4244/eij-d-17-00011
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Also Consider

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

  1. 1Balloon Predilation in Transcatheter Aortic Valve Replacement with Self-expanding Valves2018 · 1 citations
  2. 2Feasibility and safety of balloon-expandable transcatheter aortic valve implantation with moderate or without predilatation2016 · 17 citations
  3. 3Pre‐Implantation Balloon Aortic Valvuloplasty and Clinical Outcomes Following Transcatheter Aortic Valve Implantation: A Propensity Score Analysis of the UK Registry2017 · 51 citations
  4. 4Predilatation Prior to Transcatheter Aortic Valve Implantation: Is it Still a Prerequisite?2017 · 18 citations
  5. 5Balloon-expandable transfemoral transcatheter aortic valve implantation with or without predilation: findings from the prospective EASE-IT TF multicentre registry2019 · 8 citations