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Review
. 2021 Oct 12:16:e28.
doi: 10.15420/icr.2020.35. eCollection 2021 Apr.

Pre-dilation and Post-dilation in Transcatheter Aortic Valve Replacement: Indications, Benefits and Risks

Angela McInerney  1 , Rafael Vera-Urquiza  1 , Gabriela Tirado-Conte  1 , Luis Marroquin  1 , Pilar Jimenez-Quevedo  1 , Iván Nuñez-Gil  1 , Eduardo Pozo  1 , Nieves Gonzalo  1 , Jose Alberto de Agustín  1 , Javier Escaned  1 , Antonio Fernández-Ortiz  1 , Carlos Macaya  1 , Luis Nombela-Franco  1
Affiliations
Review

Pre-dilation and Post-dilation in Transcatheter Aortic Valve Replacement: Indications, Benefits and Risks

Angela McInerney et al. Interv Cardiol. .

Abstract

Transcatheter aortic valve replacement (TAVR) is an established treatment for patients with symptomatic severe aortic stenosis. In recent years, an emphasis has been placed on simplification of the procedure. Balloon predilation was initially considered a mandatory step to cross and prepare the stenotic aortic valve, but several studies demonstrated the feasibility of performing TAVR without balloon valvuloplasty. Balloon postdilation of the implanted valve is sometimes required to optimise results, although many patients do not require this step. Contemporary consensus advocates an individualised approach to TAVR procedures and so balloon pre- and post-dilation are performed selectively. This review aims to outline the advantages and disadvantages of balloon pre- and post-dilation and to identify the scenarios in which they are required during TAVR procedures.

Keywords: Transcatheter aortic valve implantation; paravalvular leak; postdilation; predilation; stroke; transcatheter aortic valve replacement.

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Conflict of interest statement

Disclosure: LNF has served as a proctor for Abbott and received speaker honoraria from Edwards Lifesciences. All other authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Advantages and Disadvantages of Balloon Pre- and Post-dilation in Transcatheter Aortic Valve Replacement
Figure 2:
Figure 2:. Decision Algorithm for Predilation in Transcatheter Aortic Valve Replacement
Figure 3:
Figure 3:. Rate of Balloon Postdilation in Current Studies with Different Transcatheter Aortic Valve Replacement Systems
Figure 4:
Figure 4:. Balloon Postdilation and Paravalvular Leak
See this image and copyright information in PMC

References

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