Balloon aortic valvuloplasty via a bilateral trans-radial artery approach prior to transcatheter aortic valve replacement

Abstract

Balloon aortic valvuloplasty (BAV) intervention is used as destination therapy or as a bridge to percutaneous or surgical aortic valve intervention. BAV is traditionally performed via a transfemoral approach; however, this may not be feasible in all patients due to peripheral vascular disease. We present a case of BAV performed via bilateral transradial access utilizing simultaneous deployment of two angioplasty balloons.

Balloon Aortic Valvuloplasty in the Transcatheter Aortic Valve Implantation Era

“…Although our work remains unreported, the technique itself has been described in three recent articles. [67][68][69] The expected reduction of vascular complications obtained by performing bilateral TRA makes this approach a great alternative in selected cases, but its superiority over the traditional femoral approach has not been demonstrated. Indeed, it can potentially increase the risk of stroke and it is not clear if the simultaneous insufflation of two non-compliant balloons can lead to a higher rate of complications associated with the valve intervention.…”

Is there still a role for balloon aortic valvuloplasty in the TAVR era?

“…In this edition of the Journal, Samuel et al report a new technique for performing BAV in patients with limited access. Their patient, a 75‐year‐old female s/p a right bilobectomy for an adenocarcinoma, presented with class 3 New York Heart Association symptoms of exertional dyspnea.…”