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Review
. 2023 Jul 27;2(4):101002.
doi: 10.1016/j.jscai.2023.101002. eCollection 2023 Jul-Aug.

Balloon Aortic Valvuloplasty in the Modern Era: A Review of Outcomes, Indications, and Technical Advances

Jeffrey Zhong  1 , Nicholas Kamp  1 , Agam Bansal  1 , Ani Kumar  1 , Rishi Puri  1 , Amar Krishnaswamy  1 , Samir Kapadia  1 , Grant W Reed  1
Affiliations
Review

Balloon Aortic Valvuloplasty in the Modern Era: A Review of Outcomes, Indications, and Technical Advances

Jeffrey Zhong et al. J Soc Cardiovasc Angiogr Interv. .

Abstract

Balloon aortic valvuloplasty (BAV) improves the hemodynamics and symptoms of patients with severe aortic stenosis in the short term with low rates of complications, but has not been shown to be an effective destination therapy. Our pooled analysis of >14,300 patients from studies published between January 1, 1991, and April 31, 2022, reported intraprocedural mortality and in-hospital mortality rates as 1.94% (95% CI, 1.39%-2.59%) and 6.02% (95% CI, 4.83%-7.32%), respectively. Hence, BAV is primarily indicated as a bridge to aortic valve replacement/decision with secondary uses as bridge to noncardiac surgery and palliative therapy. Recent advancements in alternative access sites, balloon catheters, and lithotripsy for BAV have opened opportunities for expanded use and further improvements in complication rates. As the utilization of BAV has continually increased since the advent of transcatheter aortic valve replacement, reexamining the role and outcomes of BAV in the era of transcatheter aortic valve replacement has become increasingly important. This review focuses on the outcomes, indications, advances, and technical considerations for BAV.

Keywords: aortic valve stenosis; balloon aortic valvuloplasty; outcomes; transcatheter aortic valve replacement.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

None
Graphical abstract
Figure 1
Figure 1
Forest plot of pooled analysis of studies reporting rate of death during BAV. On pooled analysis of 16 studies including 7880 patients, the rate of intraprocedural deaths during BAV was 1.94% (95% CI, 1.39%-2.59%). BAV, balloon aortic valvuloplasty.
Figure 2
Figure 2
Forest plot of pooled analysis of studies reporting rate of stroke after BAV. On pooled analysis of 23 studies including 13,751 patients, the rate of stroke after BAV was 1.27% (95% CI, 0.99%-1.57%). BAV, balloon aortic valvuloplasty.
Figure 3
Figure 3
Forest plot of pooled analysis of studies reporting rate of major vascular events after BAV. On pooled analysis of 17 studies including 9297 patients, the rate of major vascular events after BAV was 4.77% (95% CI, 3.18%-6.66%). BAV, balloon aortic valvuloplasty.
Figure 4
Figure 4
Forest plot of pooled analysis of studies reporting rate of severe acute aortic regurgitation after BAV. On pooled analysis of 13 studies including 5289 patients, the rate of severe acute aortic regurgitation after BAV was 1.31% (95% CI, 0.91%-1.78%). BAV, balloon aortic valvuloplasty.
Central Illustration
Central Illustration
Main indications, complications, and advances of BAV. BAV, balloon aortic valvuloplasty; TAVR, transcatheter aortic valve replacement; ViV, valve-in-valve.
Figure 5
Figure 5
Contemporary BAV indications and potential benefits. BAV, balloon aortic valvuloplasty; TAVR, transcatheter aortic valve replacement.
See this image and copyright information in PMC

References

    1. Cribier A., Saoudi N., Berland J., Savin T., Rocha P., Letac B. Percutaneous transluminal valvuloplasty of acquired aortic stenosis in elderly patients: an alternative to valve replacement? Lancet. 1986;327(8472):63–67. - PubMed
    1. Lieberman E.B., Bashore T.M., Hermiller J.B., et al. Balloon aortic valvuloplasty in adults: failure of procedure to improve long-term survival. J Am Coll Cardiol. 1995;26(6):1522–1528. - PubMed
    1. Percutaneous balloon aortic valvuloplasty: acute and 30-day follow-up results in 674 patients from the NHBLI Balloon Valvuloplasty Registry. Circulation. 1991;84(6):2383–2397. - PubMed
    1. Alkhouli M., Zack C.J., Sarraf M., et al. Morbidity and mortality associated with balloon aortic valvuloplasty: a national perspective. Circ Cardiovasc Interv. 2017;10(5) - PubMed
    1. Bil J., Modzelewski P., Pawlak A., Gil R.J. Balloon aortic valvuloplasty with Valver® balloon catheter in adults with severe aortic stenosis as a bridge or palliative treatment. Wiad Lek. 2021;74(7):1622–1627. - PubMed

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