Balloon Aortic Valvuloplasty as a Bridge to Aortic Valve Replacement

Kawsara, Akram; Alqahtani, Fahad; Eleid, Mackram F.; El-Sabbagh, Abdallah; Alkhouli, Mohamad

doi:10.1016/j.jcin.2019.11.041

Cited by 19 publications

(4 citation statements)

References 21 publications

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“…In our population, the median age of patients with BAV prior to TAVR was aligned with a nationwide cohort of patients in the United States, although a lower percentage of male patients (27% vs. 52%, respectively) and higher prevalence of atrial fbrillation were observed (55% vs. 45%, respectively) [16]. Te same observations are true when compared with a multicentric European registry [17].…”

Section: Discussionsupporting

confidence: 64%

“…In fact, a great proportion (43%) of patients performed TAVR after 180 days as opposed to almost 30% within 90 days (Table 1). Previous research demonstrated that BAV is not necessarily associated with such delay in TAVR implantation, as most patients wait on average 90 days after bridging BAV [15,16,22]. Dawson et al [23] demonstrated the beneft of BAV in improving symptoms may last at least 6 months.…”

Section: Discussionmentioning

confidence: 99%

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30-Day and 1-Year Mortality after Transcatheter Aortic Valve Replacement: The Impact of Balloon Aortic Valvuloplasty as a Bridging Therapy in a Portuguese Tertiary Center

Albuquerque,

Teixeira,

Grazina

et al. 2024

Journal of Interventional Cardiology

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Introduction. Since the advent and development of transcatheter aortic valve replacement (TAVR) in the contemporary era, balloon aortic valvuloplasty (BAV) has seen renewed interest. We aimed to compare 30-day and 1-year all-cause mortality between patients submitted to BAV as a bridging therapy before definite TAVR and patients submitted directly to TAVR. Methods. This was an observational, retrospective study of patients who underwent TAVR between 2009 and 2022 in a tertiary center. Patients with severe aortic stenosis (SAS) who underwent TAVR without prior BAV (woBAV group) and patients who were performed TAVR with prior BAV (wBAV group) as a bridging therapy were included. Primary endpoint was all-cause mortality at 30 days and 1 year after TAVR between wBAV and woBAV groups. Results. 800 patients were included, of which 767 were in woBAV group and 33 were in wBAV group. 30-day all-cause mortality rate was 21% in wBAV group compared to 4.4% in woBAV (unadjusted hazard ratio [HR], 5.19; 95% confidence interval [CI], 2.3–11.7, p < 0.001). At 1-year, all-cause mortality rate was 27% in wBAV group compared to 12% in woBAV group (unadjusted HR, 2.55; 95% CI, 1.28–5.10, p = 0.007). After covariate adjustments, mortality remained significantly higher in wBAV group. Conclusion. This study provides valuable insights into the outcomes of patients undergoing TAVR with prior BAV as bridging therapy, as these patients had higher mortality at 30 days and 1 year compared to patients direct to TAVR.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

30-Day and 1-Year Mortality after Transcatheter Aortic Valve Replacement: The Impact of Balloon Aortic Valvuloplasty as a Bridging Therapy in a Portuguese Tertiary Center

Albuquerque,

Teixeira,

Grazina

et al. 2024

Journal of Interventional Cardiology

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“…European and US guidelines recommend BAV as a bridge to further interventions in hemodynamically unstable patients [ 31 , 32 ]. It can also be offered as stand-alone option to patients with limited life expectancy or unsuitable for TAVR or as temporary measure in the setting of acute advanced AS [ 33 , 34 ]. An overview of studies reporting outcomes of BAV is reported in Table 1 .…”

Section: Percutaneous Bavmentioning

confidence: 99%

Acute advanced aortic stenosis

et al. 2023

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Acute decompensation often represents the onset of symptoms associated with severe degenerative aortic stenosis (AS) and usually complicates the clinical course of the disease with a dismal impact on survival and quality of life. Several factors may derange the faint balance between left ventricular preload and afterload and precipitate the occurrence of symptoms and signs of acute heart failure (HF). A standardized approach for the management of this condition is currently lacking. Medical therapy finds very limited application in this setting, as drugs usually indicated for the control of acute HF might worsen hemodynamics in the presence of AS. Urgent aortic valve replacement is usually performed by transcatheter than surgical approach whereas, over the last decades, percutaneous balloon valvuloplasty gained renewed space as bridge to definitive therapy. This review focuses on the pathophysiological aspects of acute advanced AS and summarizes current evidence on its management.

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“…14 Previous studies have used NRD extensively to study trends and outcomes of aortic valve interventions in the United States. 1 , 2 , 15 , 16 , 17 , 18 Because NRD and SID are publicly available and deidentified, this study was deemed exempt by the institutional review board. The data could not be made directly available for replication of the study’s results by the authors but can be obtained directly from the Healthcare Cost and Utilization Project with the appropriate data user agreement.…”

Section: Methodsmentioning

confidence: 99%