Key result
TAVI without BAV shows no increased risk of short-term adverse outcomes compared to predilation.
Why the study?
Aortic valve predilation with balloon aortic valvuloplasty before TAVI is recommended despite limited data on its necessity and potential embolization risks.
Does pre-implantation balloon aortic valvuloplasty (BAV) improve short-term outcomes in patients undergoing transcatheter aortic valve implantation (TAVI)?
Population
5,887 patients undergoing TAVI in the UK between 2007 and 2014
Comparison
TAVI with pre-implantation BAV vs TAVI without pre-implantation BAV
Design
Propensity score analysis of UK TAVI registry cohort
Follow-up
30 days
Authors
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Supports omitting routine predilation in selected TAVI patients; hypothesis-generating and requires randomized confirmation before practice change.
Cohort (n=5,887)
Yes
Does pre-implantation balloon aortic valvuloplasty (BAV) improve short-term outcomes in patients undergoing transcatheter aortic valve implantation (TAVI)?
Performing TAVI without pre-implantation balloon aortic valvuloplasty appears safe and is not associated with adverse short-term outcomes compared to routine predilation.
Martin et al. (2017) conducted a cohort in Transcatheter aortic valve implantation (TAVI) (n=5,887). Pre-implantation balloon aortic valvuloplasty (BAV) vs. No BAV (TAVI without predilation) was evaluated on Short-term outcomes including 30-day mortality, myocardial infarction, aortic regurgitation, valve dysfunction, and composite early safety. Performing TAVI without pre-implantation balloon aortic valvuloplasty was not associated with adverse short-term outcomes compared to predilation in a propensity-matched analysis of 5,887 patients.
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