Balloon aortic valvuloplasty

Summary

Balloon aortic valvuloplasty has become a straightforward and relatively safe procedure that plays an increasingly useful role as a part of a TAVI procedure and as an adjunct in the management of aortic stenosis, in particular, as a bridge to a more definitive procedure.

Background

Calcific aortic stenosis (AS) is the most frequent valvular heart disease in the Western world. Its prevalence increases with age. Community data documents the prevalence of moderate or severe AS as 0.6%, 1.4% to 4.6% in patients aged 55 to 64, 65 to 74, and ≥75 years of age, respectively 11. Nkomo VT, Gardin JM, Skelton TN, Gottdiener JS, Scott CG, Enriquez-Sarano M. Burden of valvular heart diseases: a population-based study. Lancet. 2006 Sep 16;368(9540):1005-11. Link. Once moderate AS is present progression is somewhat predictable with an average reduction in aortic valve area of 0.1cm2/year 22. Rosenhek R, Binder T, Porenta G, Lang I, Christ G, Schemper M, Maurer G, Baumgartner H. Predictors of outcome in severe, asymptomatic aortic stenosis. N Engl J Med. 2000;343:611-7. Link, and simultaneous increase in the transvalvular gradient, eventually resulting in typical symptoms of angina, syncope and heart failure. Once these symptoms are...