Open balloon aortic valvuloplasty in XXXX : implications for transcatheter aortic valve implantations.

@entity1 @entity340 @entity64 @entity174 @entity730 @entity472
Balloon aortic valvuloplasty (BAV) plays a crucial role in transcatheter aortic valve implantation (TAVI). However, data on morphology during BAV are lacking. During surgical aortic valve replacement, open BAV was performed as a non-therapeutic in-vivo model prior to aortic valve excision. Twenty-six @entity1 with severe @entity472 were included in the study after ethics committee approval. A valvuloplasty balloon was advanced from the open aorta, across the stenotic aortic valve and was rapidly inflated and deflated. All @entity1 except for one had tricuspid aortic valves with severe visible @entity730 on the aortic side of leaflets. All valves were successfully dilated. Only in the presence of severe central calcific noduli, @entity174 occurred in the middle portion of the leaflets in three and in the commissural part in four @entity1 . No embolization of @entity340 occurred, however, ten coronary leaflets partially reached coronary orifices, resulting in three near-obstructions. The present study visualized for the first time the behaviour of bulky leaflet calcifications during valvuloplasty. @entity174 in the middle portion of the free edge may occur whenever a huge @entity730 completely affects the whole leaflet area. No signs of embolization were observed, possibly explaining low @entity64 rates during TAVI procedures.
