Complications and Outcome of Balloon Aortic Valvuloplasty in High-Risk or Inoperable Patients

Abstract

Long-term survival is poor after BAV alone. BAV as a bridge to percutaneous or surgical aortic valve replacement is feasible, safe, and associated with better outcome than BAV alone.

Valvuloplastia aórtica por cateter balão na estenose aórtica degenerativa: impacto terapêutico em pacientes em condição clínica in extremis

“…9,17,18 A study of 262 patients at high surgical risk undergoing BAV showed that creatinine clearance ≤ 60 mL/min before the procedure is a strong predictor of mortality. 7 The absence of vascular complications in this study may be related to the use of sheaths with small calibre (10F) in all patients, as well as to the immediate withdrawal of the sheath. Despite being related to a shorter hospital stay and a lower rate of blood transfusions in these cases, mortality was 50%.…”

“…Other studies involving only patients undergoing BAV also included patients with less severe conditions compared to the present study, with lower incidence of comorbidities and with lower risk scores. 6,7,[11][12][13][14] Most patients (73.7%) showed renal failure at the time of the procedure, and most had pulmonary artery pressure > 60 mmHg. Both conditions have been associated to an increase in mortality in earlier studys.…”

“…Recently, some studies have addressed the use of BAV as a bridge to TAVI, showing excellent results in the short and long term, when compared to BAV alone. [6][7][8] The classification of patients according to the number of organ dysfunctions presented was of great importance to the understanding that there is a subgroup of more severe patients who evolve unfavourably, even after BAV. Patients with two or more organ dysfunctions had significantly higher mortality when compared to patients in the control group.…”

“…2,[6][7][8] Its low cost and wide availability in most cardiology centers justify its use for patients with prohibitive surgical risk, despite the high recurrence rate of symptoms and its ineffectiveness in reducing mortality. 9,10 The best time to perform the BAV, in the context of symptomatic aortic stenosis, has not yet been defined.…”

Balloon valvuloplasty in adults with severe aortic stenosis

“…Рестеноз и, как след-ствие, рост градиента на АК очевидны в течение не-скольких дней после баллонной пластики у всей иссле-дуемой группы пациентов. Рубцовые ткани быстро за-полняют разрывы между спайками, микроповреждения самого клапана, а также трещины кальцификатов [3,31]. Все это позволяет сегодня рассматривать БВ ПАК как вспомогательный этап перед хирургической коррекцией АК.…”