Heart Failure and “Inoperable” Aortic Stenosis: Staged Balloon Aortic Valvuloplasty and Aortic Valve Bypass

Abstract

The prognosis for patients with symptomatic aortic stenosis is poor but is improved significantly by surgical aortic valve replacement. Unfortunately, many patients are refused surgery because of age, comorbidities, and hemodynamic instability. This report describes the successful use of balloon aortic valvuloplasty as a bridge to aortic valve bypass surgery (apicoaortic conduit) in an elderly patient with class IV congestive heart failure and severe left ventricular systolic dysfunction as a consequence of aortic stenosis who was not a candidate for traditional surgical valve replacement.

Standalone balloon aortic valvuloplasty: Indications and outcomes from the UK in the transcatheter valve era

“…It has been successfully used to improve cardiac performance in higher risk patients awaiting TAVI and also to provide evidence of therapeutic potential in patients with low‐flow, low‐gradient aortic stenosis. The use of BAV as a bridge to sAVR has been shown in both the pre‐ and post‐TAVI eras and, indeed, in our study 7.0% of patients who underwent BAV went on to have sAVR. However, the period studied represents the initial introduction of TAVI into the UK (and includes small data collection prior to the start of large‐scale TAVI activity).…”