Balloon aortic valvuloplasty in contemporary practice.
BACKGROUND
There has been a revival of balloon aortic valvuloplasty (BAV) for severe aortic stenosis, as a result of an increasing number of patients undergoing trans-catheter aortic valve implantation (TAVI). However, there has not been universal adoption of BAV as a standalone, nor bridging therapy.


METHODS
A retrospective analysis of the practice at our institution between June 2009 and May 2016 was performed. Demographic, clinical, procedural, and follow-up data on all patients were collected.


RESULTS
A total of 200 patients with a median age of 82 years and severe symptomatic aortic stenosis underwent BAV from June 2009 to May 2016. All patients had appreciable comorbidity with a mean logistic Euro SCORE of 48 ± 11 and mean standard Euro SCORE 15 ± 4. BAV was performed for palliation in 118 (59%), as a bridging therapy for TAVI in 55 (27.5%) and bridging to surgical AVR in 27 patients (13.5%), respectively. Major complications occurred in 14 patients (7%) including 2 in-patient deaths (1%). A statistically significant improvement in symptoms and a decrease in trans-valvular gradient were observed.


CONCLUSION
BAV is an effective treatment strategy, either as a bridge to definitive therapy or as a palliative procedure, with an acceptable mortality. BAV is associated with a significant improvement in symptoms and is valuable as a palliative treatment in high-risk patients, where no other invasive option is available.
['Sandhu|Kully|K|http://orcid.org/0000-0001-6026-1999', 'Krishnamoorthy|Suresh|S|', 'Afif|Ashari|A|', 'Nolan|James|J|', 'Gunning|Mark G|MG|']
D000368:Aged D000369:Aged, 80 and over D001021:Aortic Valve D001024:Aortic Valve Stenosis D063126:Balloon Valvuloplasty D015897:Comorbidity D005260:Female D006801:Humans D008297:Male D010166:Palliative Care D012189:Retrospective Studies D012307:Risk Factors D012720:Severity of Illness Index D013997:Time Factors D016896:Treatment Outcome D006113:United Kingdom
aortic valve disease percutaneous valve therapy structural heart disease intervention