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Initial findings using the V8 hourglass‐shaped valvuloplasty balloon for postdilatation in treating paravalvular leaks associated with transcatheter self‐expanding aortic valve prosthesis
Author(s) -
Latib Azeem,
Pedersen Wesley,
Maisano Francesco,
Lesser John,
Ruparelia Neil,
Figini Filippo,
Colombo Antonio,
Poulose Anil,
Kolbeck James,
Mooney Michael,
Schwartz Robert,
Youssef Alicia,
Ungs David,
Goldenberg Irv,
Sorajja Paul
Publication year - 2016
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26462
Subject(s) - medicine , valve replacement , balloon , stenosis , cardiology , surgery , prosthesis , aortic valve , radiology
Objectives The aim of this study was to assess the effect of a novel hourglass‐shaped balloon on reduction of paravalvular leak (PVL) in patients undergoing transcatheter aortic valve replacement (TAVR) with self‐expanding prostheses. Background An important limitation of TAVR compared with surgical aortic valve replacement remains the higher incidence of PVL. A commonly used strategy to treat PVL is balloon postdilatation (BPD); however, the optimal technique for treating PVL after TAVR is unknown. Methods We examined consecutive patients with severe, symptomatic aortic stenosis who underwent TAVR with the Medtronic CoreValve followed by BPD with an InterValve V8 balloon for PVL grade ≥2+. Data from echocardiographic, multidetector computed tomographic, and angiographic images were reviewed. The primary endpoint was successful reduction in PVL to grade 1+ or less as assessed by intraprocedural echocardiography. Results Eleven patients were studied (median age, 82 years; 64% female). Ten patients (91%) demonstrated successful reduction in PVL after V8 BPD. In three patients, PVL was reduced to zero or trace. PVL remained unchanged in one patient (2+). Two patients had complete heart block associated with valve deployment and received permanent pacemakers. There were no occurrences of annular injury or major adverse clinical events. Conclusions BPD with the V8 hourglass‐shaped balloon was feasible in reducing PVL from self‐expanding TAVR prostheses. © 2016 Wiley Periodicals, Inc.