Acute and long‐term outcomes of percutaneous balloon aortic valvuloplasty for the treatment of severe aortic stenosis

Daniec, Marzena; Nawrotek, Bartłomiej; Sorysz, Danuta; Rakowski, Tomasz; Dziewierz, Artur; Rzeszutko, Łukasz; Kleczyński, Paweł; Trębacz, Jarosław; Tomala, Marek; Żmudka, Krzysztof; Dudek, Dariusz

doi:10.1002/ccd.26697

Cited by 22 publications

(23 citation statements)

References 22 publications

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“…We did not manage to prove this phenomenon in the group of patients who underwent BAV and PCI which was probably due to a small sample size. However, in many previous studies both procedures were shown to separately contribute to the improvement of LVEF . Despite the lack of statistical significance, our study suggests that coronary revascularization can magnify effect of BAV on LVEF improvement and further results in a higher survival.…”

Section: Discussioncontrasting

confidence: 66%

In‐hospital and long‐term outcomes of percutaneous balloon aortic valvuloplasty with concomitant percutaneous coronary intervention in patients with severe aortic stenosis

Daniec

Sorysz

Dziewierz

et al. 2017

J Interven Cardiology

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Section: Discussioncontrasting

confidence: 66%

In‐hospital and long‐term outcomes of percutaneous balloon aortic valvuloplasty with concomitant percutaneous coronary intervention in patients with severe aortic stenosis

Daniec

Sorysz

Dziewierz

et al. 2017

J Interven Cardiology

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“…Moreover, BAV alone may be considered as a bridge to aortic valve replacement (AVR) or TAVR in symptomatic patients with AS who are poor candidates for any definitive treatment due to severe comorbidities [1]. Additionally, BAV sometimes allows patients with severe AS to undergo an urgent non-cardiac surgery with its good immediate result [2,7]. In the current study, we evaluated a technical feature of the pacing method during BAV with direct LV pacing via guidewire.…”

Section: Discussionmentioning

confidence: 99%

“…In a specific subset of patients with symptomatic aortic valve stenosis (AS), who are poor candidates for any definitive treatment due to severe comorbidities, balloon aortic valvuloplasty (BAV) can either serve as a standalone palliative procedure or as a bridge to final therapy [1]. Moreover, BAV allows patients with severe AS to undergo an urgent non-cardiac surgery with its good immediate result [2]. On the contrary to a transcatheter aortic valve replacement (TAVR), the long-term clinical and hemodynamic outcomes of BAV were shown to be rather poor [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Direct Rapid Left Ventricular Wire Pacing during Balloon Aortic Valvuloplasty

Kleczyński

Dziewierz

Socha

et al. 2020

JCM

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Background: Rapid ventricular pacing is mandatory for optimal balloon positioning during aortic valvuloplasty (BAV) in patients with severe aortic stenosis. We aimed to assess the safety and efficacy of direct left ventricular (LV) guidewire pacing in comparison with regular pacing induced by temporary pacemaker (PM) placement in the right ventricle. Methods: Direct rapid LV pacing was provided with a 0.035″ guidewire. Baseline clinical characteristics, echocardiographic and procedural data, as well as complication rates, were compared between the two groups. Results: A total of 202 patients undergoing BAV were enrolled (49.5% with direct LV guidewire pacing). The pacing success rate was 100%. In the direct LV guidewire pacing group, we found a lower radiation dose, shorter fluoroscopy and overall procedural time (0.16 vs. 0.28 Gy, p = 0.02; 5.4 vs. 10.3 min, p = 0.01; 17 vs. 25 min, p = 0.01; respectively). In addition, the complication rate was lower in that group (cardiac tamponades, vascular access site complications, blood transfusions rate, and in-hospital mortality: 0% vs. 3.9%; 4.0% vs. 15.7%; 2.0% vs. 12.7%; 2.0% vs. 9.8%, p = 0.01 for all, respectively). Conclusions: Direct rapid LV guidewire pacing is a simple, safe and effective option for BAV with a reduced complication rate compared to a temporary PM placed in the right ventricle.

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“…Patients with coexisting severely abnormal LVEF and LGAS exhibited the worst outcome.In multivariate analysis, only LGAS was associated with increased 1-year mortality after TAVI with no modifying effect of LVEF on outcome 27. Alternatively, bridging balloon aortic valvuloplasty may represent a therapeutic option in these patients, with a subsequent TAVI procedure in those who demonstrate clinical improvement 32,33. This applies to the majority of patients undergoing TAVI.…”

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confidence: 99%

Impact of baseline left ventricular ejection fraction on outcome after transfemoral transcatheter aortic valve implantation in patients with and without low‐gradient aortic stenosis

et al. 2018

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Objectives:To evaluate the impact of baseline left ventricular ejection fraction (LVEF) and its interaction with low-gradient aortic stenosis (LGAS) on all-cause mortality after transfemoral aortic valve implantation (TF-TAVI). Methods:We reviewed mortality data of 624 consecutive single center TF-TAVI patients and categorized LVEF according to current ASE/EACVI recommendations (normal, mildly-, moderately-, and severely abnormal). Results:Baseline LVEF was normal in 336 (53.8%), mildly abnormal in 160 (25.6%), moderately abnormal in 91 (14.6%), and severely abnormal in 37 (5.9%) patients, and 1-year mortality was 19%, 17%, 23%, and 43% (P = 0.002), respectively. Patients with LGAS had a similar 1-year mortality compared to those without LGAS in groups with normal (19% vs 19%, P = 0.899) and mildly abnormal LVEF (16% vs 17%, P = 0.898). One-year mortality of patients with LGAS was significantly greater than in those without LGAS in presence of moderately abnormal LVEF (31% vs 11%, P = 0.022), and it was numerically greater than in those without LGAS in presence of severely abnormal LVEF (48% vs 25%, P = 0.219). In multivariate analysis, only the combination of moderately/severely abnormal LVEF and LGAS predicted increased 1-year mortality (HR: 2.12, 95% CI: 1.4-3.2, P < 0.001). Other variables, including EuroSCORE I did not affect this result. Conclusions:Moderately/severely abnormal LVEF (≤40%) at baseline is associated with increased mortality after TF-TAVI, especially when the mean transvalvular aortic gradient is <40 mm Hg (LGAS), while outcomes in patients with normal and mildly abnormal LVEF are comparable regardless of the pressure gradient across the native aortic valve. (DRKS00013729). K E Y W O R D Sleft ventricular ejection fraction, low-gradient aortic stenosis, mortality, transfemoral aortic valve implantation | 29 EL-CHILALI Et AL.

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Acute and long‐term outcomes of percutaneous balloon aortic valvuloplasty for the treatment of severe aortic stenosis

Abstract: BAV is a useful procedure in high-risk AS patients, where achieved effects can be sufficient in bridging patients for TAVI/AVR. © 2016 Wiley Periodicals, Inc.

Cited by 22 publications

References 22 publications

In‐hospital and long‐term outcomes of percutaneous balloon aortic valvuloplasty with concomitant percutaneous coronary intervention in patients with severe aortic stenosis

In‐hospital and long‐term outcomes of percutaneous balloon aortic valvuloplasty with concomitant percutaneous coronary intervention in patients with severe aortic stenosis

Direct Rapid Left Ventricular Wire Pacing during Balloon Aortic Valvuloplasty

Impact of baseline left ventricular ejection fraction on outcome after transfemoral transcatheter aortic valve implantation in patients with and without low‐gradient aortic stenosis

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