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 1. Once moderate AS is present progression is somewhat predictable with an average reduction in aortic valve area of 0.1cm2/year 2, and simultaneous increase in the transvalvular gradient, eventually resulting in typical symptoms of angina, syncope and heart failure. Once these symptoms...
Sign up for free!
Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com
- Cribier A, Savin T, Saoudi N, Rocha P, Berland J, Letac B. Percutaneous transluminal valvuloplasty of acquired aortic stenosis in elderly patients: an alternative to valve replacement? Lancet. 1986;63-7.
- Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, Iung B, Lancellotti P, Lansac E, Rodriguez Muñoz D, Rosenhek R, Sjögren J, Tornos Mas P, Vahanian A, Walther T, Wendler O, Windecker S, Zamorano JL; ESC Scientific Document Group. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J 2017;38:2739-2791.
- Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O’Gara PT, Rigolin VH, Sundt TM 3rd, Thompson A. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017;70:252-289.
- Webb JG, Pasupati S, Achtem L, Thompson CR. Rapid pacing to facilitate transcatheter prosthetic heart valve implantation. Catheter Cardiovasc Interv. 2006;68:199-204.
- Eltchaninoff H, Cribier A, Tron C, Anselme F, Koning R, Soyer R, Letac B. Balloon aortic valvuloplasty in elderly patients at high risk for surgery, or inoperable. Immediate and mid-term results. Eur Heart J. 1995;16:1079-84.
- Berland J, Cribier A, Savin T, Lefebvre E, Koning R, Letac B. Percutaneous balloon valvuloplasty in patients with severe aortic stenosis and low ejection fraction. Immediate results and 1-year follow-up. Circulation. 1989;79:1189-96.
- Boone RH WJ. Nonsurgical aortic valve therapy: Balloon valvuloplasty and transcatheter aortic valve replacement. In: Yusuf S CJ, Camm J, Fallen E, Gersh B, editor. Evidence Based Cardiology. 3rd ed. Oxford: Blackwell Publishing; 2008.
- Agarwal A, Kini AS, Attanti S, Lee PC, Ashtiani R, Steinheimer AM, Moreno PR, Sharma SK. Results of repeat balloon valvuloplasty for treatment of aortic stenosis in patients aged 59 to 104 years. Am J Cardiol. 2005;95:43-7.
- Letac B, Cribier A, Eltchaninoff H, Koning R, Derumeaux G. Evaluation of restenosis after balloon dilatation in adult aortic stenosis by repeat catheterization. American Heart Journal. 1991;122(1 Pt 1):55-60.
- Doguet F, Godin M, Lebreton G, Eltchaninoff H, Cribier A, Bessou J-P, Litzler P-Y. Aortic valve replacement after percutaneous valvuloplasty. An approach in otherwise inope-rable patients. Eur J CardioThorac Surg 2010;28:394-9.