Incidence, treatment, and outcome of acute aortic valve regurgitation complicating percutaneous balloon aortic valvuloplasty

Abstract

AAR is a fearsome complication of BAV and portends a grim prognosis. In some cases, it can be resolved with appropriate technical maneuvers; in others, a rescue TAVI or surgical valve replacement may be necessary. © 2015 Wiley Periodicals, Inc.

Randomized comparison of balloon aortic valvuloplasty performed with or without rapid cardiac pacing: The pacing versus no pacing (PNP) study

“…We would like to highlight that the study protocol mandated balloon inflation at a nominal pressure, so as not to determine any bias between the groups. At our institute, BAV was usually performed without RP, allowing the operator to adapt inflation pressure upon aortic valve sealing, at times even over‐expanding the balloon . The predefined less aggressive approach adopted in this trial might have influenced the final efficacy outcome.…”

“…Likewise, for safety reasons, the operator is discouraged from upgrading balloon size even in the presence of a suboptimal procedural result. When rapid pacing is applied, the pressure curve is abolished due to deliberately ineffective contractions and so the operator cannot rely on the sealing concept (Figure B) …”

Safety and Efficacy of Simultaneous Biplane Mode of 3-Dimensional Transesophageal Echocardiography-Guided Antegrade Multiple-Inflation Balloon Aortic Valvuloplasty in Patients With Severe Aortic Stenosis

“…7,8,12-14 For example, a previous study reported a 1.7% incidence rate of acute AR, with 50% of this incidence occurring just after the first inflation of the balloon. 21, 23 We speculate that our protocol of gradual upsizing of the balloon by inflation under biplane-TEE monitoring contributed to avoiding acute AR caused by a forced excessive valve dilatation, as well as avoiding rupture of the annulus by an excessively oversized balloon. 5,7, 24 Moreover, the antegrade approach has the potential to injure the mitral valve apparatus, which results in acute MR; the Brockenbrough procedure for the transseptal approach has a risk of cardiac tamponade.…”

A Rare Cause of Cardiogenic Shock: A Case Report of Aortic Regurgitation due to Rupture of a Fibrous Strand Suspending a Tricuspid Aortic Valve

“…In the majority of cases, acute AR is caused by either infective endocarditis of the aortic valve or an aortic dissection. 1,2 In rare cases, acute AR is caused by a traumatic rupture of valve leaflets, 3 due to complications of procedures such as aortic balloon valvotomy 4 or rupture of fenestrated cusps. 5 A few cases of AR in the presence of fibrous strands have been reported.…”