+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Balloon-expandable transaortic transcatheter aortic valve implantation with or without predilation



Balloon-expandable transaortic transcatheter aortic valve implantation with or without predilation



Journal of Thoracic and Cardiovascular Surgery 155(3): 915-923



It has been reported that balloon aortic valvuloplasty immediately before transfemoral or transapical transcatheter aortic valve implantation has mostly little to no clinical value. We aimed to provide data on the need for balloon aortic valvuloplasty in patients undergoing transaortic transcatheter aortic valve implantation. Patients undergoing transaortic transcatheter aortic valve implantation with the Edwards SAPIEN XT (Nyon, Switzerland) or 3 transcatheter heart valve were prospectively included at 18 sites across Europe. In the present analysis, we compare the periprocedural and 30-day outcomes of patients undergoing conventional (+ balloon aortic valvuloplasty) versus direct (- balloon aortic valvuloplasty) transaortic transcatheter aortic valve implantation. Of the 300 patients enrolled, 222 underwent conventional and 78 underwent direct transaortic transcatheter aortic valve implantation. Peak and mean transvalvular gradients were improved in both groups with no significant difference between groups. Procedural duration, contrast agent volume, and requirement for postdilation were also comparable. A trend toward fewer periprocedural complications was evident in the direct group (3.9% vs 11.3%; P = .053), with significantly lower rates of permanent pacemaker implantation (0% vs 5.0%; P = .034). Balloon aortic valvuloplasty omission had no significant effect on any of the 30-day safety and efficacy outcomes, including Valve Academic Research Consortium-2 composite end points (early safety events: 22.7% vs 17.4%, odds ratio, 1.17, 95% confidence interval, 0.53-2.62; clinical efficacy events: 20.5% vs 18.7%, odds ratio, 1.14, 95% confidence interval, 0.51-2.55). For many patients, balloon aortic valvuloplasty predilation seems to have little clinical value in transaortic transcatheter aortic valve implantation using a balloon expandable transcatheter valve and may result in a higher rate of periprocedural complications, particularly in terms of permanent pacemaker implantation.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 052062642

Download citation: RISBibTeXText

PMID: 29221741

DOI: 10.1016/j.jtcvs.2017.10.071


Related references

"Buddy wire" technique in transcatheter aortic valve implantation with a balloon-expandable valve: A rescue option in the setting of direct valve implantation (without predilation). Archivos de Cardiologia de Mexico 86(2): 180-182, 2016

Balloon-expandable transapical transcatheter aortic valve implantation with or without predilation of the aortic valve: results of a multicentre registry. European Journal of Cardio-Thoracic Surgery 53(4): 771-777, 2018

Omission of predilation in balloon-expandable transcatheter aortic valve implantation: retrospective analysis in a large-volume centre. Eurointervention 13(2): E161, 2017

Predictive ability of the CHADS2 and CHA2DS2-VASc scores for stroke after transcatheter aortic balloon-expandable valve implantation: an Italian Transcatheter Balloon-Expandable Valve Implantation Registry (ITER) sub-analysis. European Journal of Cardio-Thoracic Surgery 50(5): 867-873, 2016

Feasibility And Safety Of Early Discharge After Direct Transaortic Transcatheter Aortic Valve Implantation Using A Balloon-Expandable System. Canadian Journal of Cardiology 31(10): S185-S186, 2015

Transaortic transcatheter aortic valve replacement through a right minithoracotomy with the balloon-expandable Sapien 3 valve. Multimedia Manual of Cardiothoracic Surgery 2016:, 2016

Early and mid-term outcomes of 1904 patients undergoing transcatheter balloon-expandable valve implantation in Italy: results from the Italian Transcatheter Balloon-Expandable Valve Implantation Registry (ITER). European Journal of Cardio-Thoracic Surgery 50(6): 1139-1148, 2016

Transaortic balloon-expandable aortic valve implantation. Journal of Thoracic and Cardiovascular Surgery 143(6): 1453-1455, 2012

Acute ascending aortic dissection during transaortic balloon-expandable aortic valve implantation. Journal of Thoracic and Cardiovascular Surgery 144(3): E97, 2012

Aortic annulus eccentricity before and after transcatheter aortic valve implantation: comparison of balloon-expandable and self-expandable prostheses. European Heart Journal 34(Suppl 1): P271-P271, 2013

Meta-Analysis of the Effectiveness and Safety of Transcatheter Aortic Valve Implantation Without Balloon Predilation. American Journal of Cardiology 117(10): 1629-1635, 2016

Transcatheter aortic valve implantation without balloon predilation: a single-center pilot experience. Catheterization and Cardiovascular Interventions 82(2): 292-297, 2013

Meta-analysis of the Impact of Avoiding Balloon Predilation in Transcatheter Aortic Valve Implantation. American Journal of Cardiology 122(3): 477-482, 2018

Long-term outcomes with balloon-expandable and self-expandable prostheses in patients undergoing transfemoral transcatheter aortic valve implantation for severe aortic stenosis. International Journal of Cardiology 290: 45-51, 2019

TCT-156 Outcomes After Transcatheter Aortic Valve Implantation Using a Novel Balloon-Expandable Transcatheter Heart Valve: A Single Center Experience. Journal of the American College of Cardiology 66(15): B55-B56, 2015