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Safety and feasibility of balloon aortic valvuloplasty in non‐TAVI centers: The “BAV for life” experience
Author(s) -
Attisano Tiziana,
Silverio Angelo,
Stabile Eugenio,
Briguori Carlo,
Tuccillo Bernardino,
Scotto Di Uccio Fortunato,
Di Lorenzo Emilio,
Tesorio Tullio,
Giordano Arturo,
Calabrò Paolo,
Cappelli Bigazzi Maurizio,
Golino Paolo,
Scherillo Marino,
Vigorito Francesco,
Quaranta Gaetano,
Esposito Giovanni,
Mauro Ciro,
Musumeci Giuseppe,
Tarantini Giuseppe,
Galasso Gennaro
Publication year - 2019
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.27820
Subject(s) - medicine , aortic valvuloplasty , ejection fraction , stenosis , cardiology , balloon , aortic valve , aortic valve stenosis , group b , aortic valve replacement , heart failure , surgery
Objectives To evaluate the safety and the feasibility of balloon aortic valvuloplasty (BAV) procedure made by trained operators in centers not performing transcatheter aortic valve implantation (TAVI). Background BAV is a valuable therapeutic tool for patients with symptomatic severe aortic valve stenosis (AS) at prohibitive risk for TAVI or surgery. Methods Consecutive high‐risk AS patients underwent BAV in five non‐TAVI centers, where BAV operators had completed a 6‐month training period in high‐volume TAVI centers (Group A). All clinical, echocardiographic, and procedural data were prospectively collected and compared with data of patients treated in TAVI center (Group B). Results Between June 2016 and June 2017, 55 patients (83.9 ± 7.0 years) were enrolled: 25 in Group A and 30 in Group B. After BAV, a substantial reduction of the peak‐to‐peak aortic valve gradient was obtained in both groups (−35.3 ± 15.2 vs −28.8 ± 13.9 mmHg, P =0.25). No major bleeding or vascular complications occurred. In‐hospital death was observed in three patients of Group A and two patients of Group B ( P =0.493). The mean follow‐up time was 303 ± 188 days; no patients were lost. The 1‐year survival free from overall death (Group A 75.8% vs Group B 68.8%; P =0.682) and heart failure rehospitalization (Group A 73.0% vs Group B 66.8%; P =0.687) was similar in the two groups. At multivariable analysis, low left ventricular (LV) ejection fraction (HR: 0.943; P = 0.011) and cardiogenic shock (HR: 5.128; P = 0.002) at admission were independent predictors of mortality. Conclusions BAV is a safe and effective procedure that can be performed by trained operators in centers not performing TAVI.