scholarly journals Balloon Aortic Valvuloplasty for Severe Aortic Stenosis as Rescue or Bridge Therapy

2021 ◽  
Vol 10 (20) ◽  
pp. 4657
Author(s):  
Pawel Kleczynski ◽  
Aleksandra Kulbat ◽  
Piotr Brzychczy ◽  
Artur Dziewierz ◽  
Jaroslaw Trebacz ◽  
...  
Keyword(s):  
Time Window ◽  
Severe Aortic Stenosis ◽  
Patient Flow ◽  
Cardiac Surgical Procedures ◽  
Lv Function ◽  
Bridge To Surgery ◽  
Balloon Aortic Valvuloplasty ◽  
Primary Indication ◽  
Aortic Valvuloplasty ◽  
Bridge Therapy

The study aimed to assess procedural complications, patient flow and clinical outcomes after balloon aortic valvuloplasty (BAV) as rescue or bridge therapy, based on data from our registry. A total of 382 BAVs in 374 patients was performed. The main primary indication for BAV was a bridge for TAVI (n = 185, 49.4%). Other indications included a bridge for AVR (n = 26, 6.9%) and rescue procedure in hemodynamically unstable patients (n = 139, 37.2%). The mortality rate at 30 days, 6 and 12 months was 10.4%, 21.6%, 28.3%, respectively. In rescue patients, the death rate raised to 66.9% at 12 months. A significant improvement in symptoms was confirmed after BAV, after 30 days, 6 months, and in survivors after 1 year (p < 0.05 for all). Independent predictors of 12-month mortality were baseline STS score [HR (95% CI) 1.42 (1.34 to 2.88), p < 0.0001], baseline LVEF <20% [HR (95% CI) 1.89 (1.55–2.83), p < 0.0001] and LVEF <30% at 1 month [HR (95% CI) 1.97 (1.62–3.67), p < 0.0001] adjusted for age/gender. In everyday clinical practice in the TAVI era, there are still clinical indications to BAV a standalone procedure as a bridge to surgery, TAVI or for urgent high risk non-cardiac surgical procedures. Patients may improve clinically after BAV with LV function recovery, allowing to perform final therapy, within limited time window, for severe AS which ameliorates long-term outcomes. On the other hand, in patients for whom an isolated BAV becomes a destination therapy, prognosis is extremely poor.

A Novel Approach: Trans-ascending Aorta Balloon Aortic Valvuloplasty via Sternotomy for Treating Severe Valvular Aortic Stenosis in a Low-Weight Infant

2014 ◽  
Vol 17 (1) ◽  
pp. 25 ◽  
Author(s):  
Lei Gao ◽  
Qin Wu ◽  
Xinhua Xu ◽  
Tianli Zhao ◽  
Wancun Jin ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Transesophageal Echocardiography ◽  
Severe Aortic Stenosis ◽  
Ascending Aorta ◽  
Balloon Aortic Valvuloplasty ◽  
Congenital Aortic Stenosis ◽  
Novel Approach ◽  
Low Weight ◽  
Aortic Valvuloplasty ◽  
Peak Gradient

<p><b>Background:</b> Severe congenital aortic stenosis in infants is a life-threatening congenital heart anomaly that is typically treated using percutaneous balloon aortic valvuloplasty.</p><p><b>Methods:</b> The usual route is the femoral artery under radiographic guidance. However, this procedure may be limited by the small size of the femoral artery in low-weight infants. An infant weighing only 7 kg with severe aortic stenosis (peak gradient was 103 mmHg) was successfully treated with a novel approach, that is trans-ascending aorta balloon aortic valvuloplasty guided by transesophageal echocardiography.</p><p><b>Results:</b> The patient tolerated the procedure well, and no major complications developed. After the intervention, transesophageal echocardiography indicated a significant reduction of the aortic valvular peak gradient from 103 mmHg to 22 mmHg, no aortic regurgitation was found. Eighteen months after the intervention, echocardiography revealed that the aortic valvular peak gradient had increased to 38 mmHg and that still no aortic regurgitation had occurred.</p><p><b>Conclusions:</b> In our limited experience, trans-ascending aorta balloon aortic valvuloplasty for severe aortic stenosis under transesophageal echocardiography guidance effectively reduces the aortic peak gradient. As this is a new procedure, long-term follow up and management will need to be established. It may be an alternative technique to treat congenital aortic stenosis in low-weight patients.</p>

Abstract 19440: Reintervention Rates Following Balloon Aortic Valvuloplasty versus Surgical Valve Repair in Isolated Congenital Aortic Valve Stenosis - A Meta-analysis

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
May T Saung ◽  
Courtney McCracken ◽  
Ritu Sachdeva ◽  
Christopher J Petit
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Stenosis ◽  
Meta Analysis ◽  
Valve Repair ◽  
Balloon Aortic Valvuloplasty ◽  
Congenital Aortic Stenosis ◽  
Primary Indication ◽  
Aortic Valvuloplasty

Introduction: The optimal treatment for congenital aortic stenosis (AS) is debated despite decades of experience with both balloon aortic valvuloplasty (BAV) and surgical aortic valve repair (SAV). While BAV has been the mainstay of therapy for AS, recent single-center reports suggest optimal results following SAV. Hypothesis: We propose that reintervention rates following SAV and BAV are equivalent. Methods: We queried Medline, EMBASE and Web of Science for eligible studies using the keywords: “congenital aortic stenosis”, “balloon valvotomy”, “aortic valve stenosis surgery” and “treatment outcome or reintervention”. Studies were excluded when cohort size was <20 pts, when follow-up was < 2.5 yrs from primary intervention, and when primary indication was not AS (e.g. SAV in the setting of aortic valve regurgitation (AR)). Outcomes analyzed included death, reintervention and moderate or severe AR. Analysis was performed using Comprehensive Meta Analysis v3 using random effects models. Results: A total of 20 studies were included in our meta-analysis: SAV alone (n=3), BAV alone (n=12), and both (n=5). The mean age at BAV was 3.1 years (range, 4 days - 7 years) with a mean follow-up duration of 6.8 years, while mean age at SAV was 2.8 years (range, 14.2 days - 7.1 years) with a mean follow-up duration of 9.1 years. Mortality rates following BAV and SAV were 12.3% (95% CI: 7.7 - 19.1) and 10.2% (95% CI: 7.0 - 14.5), respectively (p=0.27). Reintervention following initial procedure for treatment of AS was higher following BAV (35.7% [95% CI: 29 - 43.1]) compared to SAV (25.2% [95% CI: 19.9 - 31.3])(p=0.012). Long-term and mid-term follow-up in these studies showed moderate to severe AR was present in 24.1% and 28.1% of BAV and SAV patients, respectively. Conclusions: Notwithstanding publication bias, both survival rates and development of late AR following BAV and SAV are similar. However, reintervention rates are significantly higher following BAV compared to SAV.

scholarly journals Antegrade Balloon Aortic Valvuloplasty for the Highly Frail Patient of Severe Aortic Stenosis Complicated with Transthyretin-type Cardiac Amyloidosis

2020 ◽  
Vol 59 (8) ◽  
pp. 1053-1057
Author(s):  
Shohei Yoshida ◽  
Hayato Tada ◽  
Tetsuo Nishikawa ◽  
Tamami Nakagawa-Kamiya ◽  
Takuya Nakahashi ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Cardiac Amyloidosis ◽  
Severe Aortic Stenosis ◽  
Balloon Aortic Valvuloplasty ◽  
Frail Patient ◽  
Aortic Valvuloplasty

scholarly journals Aortic Balloon Valvuloplasty Prior to Orthotopic Liver Transplantation: A Novel Approach to Aortic Stenosis and End-Stage Liver Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Edward Coverstone ◽  
Kevin Korenblat ◽  
Jeffrey S. Crippin ◽  
William C. Chapman ◽  
Andrew M. Kates ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Orthotopic Liver Transplantation ◽  
Severe Aortic Stenosis ◽  
Balloon Aortic Valvuloplasty ◽  
End Stage Liver Disease ◽  
Aortic Valvuloplasty ◽  
End Stage

The combination of severe aortic stenosis and end-stage liver disease increases the morbidity and mortality of surgical aortic valve replacement or orthotopic liver transplantation resulting in a prohibitive operative risk. We propose a staged approach of balloon aortic valvuloplasty prior to orthotopic liver transplantation as a bridge to definitive aortic valve replacement. Between 2010 and 2012, four patients with severe aortic stenosis and end-stage liver disease underwent staged balloon aortic valvuloplasty followed by orthotopic liver transplantation. All patients had been deemed to be inappropriate candidates for liver transplantation or aortic valve surgery due to their comorbidity. One patient died of complications from a perivalvular abscess. Three patients went on to successful graft implantation and function and surgical recovery. Two of the three patients proceeded to definitive surgical aortic valve replacement with the remainder currently undergoing evaluation. In this case series, we present a novel approach of balloon aortic valvuloplasty prior to liver transplantation as a potential bridge to definitive treatment of severe aortic stenosis in the end-stage liver patient.

scholarly journals Balloon aortic valvuloplasty for urgent treatment of severe aortic stenosis during coronavirus disease 2019 pandemic: a case report

2020 ◽  
Vol 7 (6) ◽  
pp. 4348-4352
Author(s):  
Tiziana Attisano ◽  
Angelo Silverio ◽  
Michele Bellino ◽  
Carlo Tumscitz ◽  
Fabio Felice Tarantino ◽  
...  
Keyword(s):  
Case Report ◽  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Balloon Aortic Valvuloplasty ◽  
Aortic Valvuloplasty
Sign in / Sign up

Export Citation Format

Share Document