1. Safety and feasibility of balloon aortic valvuloplasty in non-TAVI centers: The 'BAV for life' experience
- Author
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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, Venuti, Angela, Maione, Antongiulio, Accadia, Maria, Spadaro, Pasquale, Arnese, Maria Rosaria, Pastore, Fabio, Eusebio, Giuseppina, De Angelis, Maria Carmen, Varricchio, Attilio, Alfieri, Alfonso, Di Girolamo, Domenico, Bianchi, Renato Maria, Visconti, Gabriella, Ambrosini, Vittorio, Capasso, Michele, Formigli, Dario, Villari, Bruno, De Simone, Ciro, Manganiello, Vincenzo, 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, Venuti, Angela, Maione, Antongiulio, Accadia, Maria, Spadaro, Pasquale, Arnese, Maria Rosaria, Pastore, Fabio, Eusebio, Giuseppina, De Angelis, Maria Carmen, Varricchio, Attilio, Alfieri, Alfonso, Di Girolamo, Domenico, Bianchi, Renato Maria, Visconti, Gabriella, Ambrosini, Vittorio, Capasso, Michele, Formigli, Dario, Villari, Bruno, De Simone, Ciro, and Manganiello, Vincenzo
- Subjects
Balloon Valvuloplasty ,Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Balloon ,Group B ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Nuclear Medicine and Imaging ,Internal medicine ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Hospital Mortality ,Prospective Studies ,aortic stenosis ,balloon aortic valvuloplasty ,transcatheter aortic valve implantation ,Radiology, Nuclear Medicine and Imaging ,Cardiology and Cardiovascular Medicine ,030212 general & internal medicine ,Aged ,Training period ,Aged, 80 and over ,Ejection fraction ,business.industry ,Cardiogenic shock ,Aortic Valve Stenosis ,Recovery of Function ,General Medicine ,aortic stenosi ,medicine.disease ,Aortic valvuloplasty ,Treatment Outcome ,Italy ,Aortic valve stenosis ,Heart failure ,Cardiology ,Feasibility Studies ,Female ,Radiology ,business - Abstract
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.
- Published
- 2018
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