Usefulness of contrast injection during balloon aortic valvuloplasty before transcatheter aortic valve replacement: a pilot study
| Autor: | Davide Capodanno, Sebastiano Immè, Daniela Giannazzo, Emanuele Benvenuto, Carmelo Sgroi, Valeria Garretto, Vera Bottari, Alessandra Giarratana, Marco Barbanti, Simona Gulino, Corrado Tamburino, Stefano Cannata, Wanda Deste, Martina Patanè, Patrizia Aruta |
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| Rok vydání: | 2014 |
| Předmět: |
Balloon Valvuloplasty
Male Cardiac Catheterization medicine.medical_specialty Aortography medicine.medical_treatment Aortic Valve Insufficiency Contrast Media Pilot Projects Regurgitation (circulation) Prosthesis Design Balloon Severity of Illness Index Prosthesis Injections Valve replacement Predictive Value of Tests Internal medicine medicine Humans Aged Aged 80 and over Heart Valve Prosthesis Implantation medicine.diagnostic_test business.industry Patient Selection Aortic Valve Stenosis medicine.disease Surgery Aortic valvuloplasty Treatment Outcome Aortic Valve Heart Valve Prosthesis Aortic valve stenosis Cardiology Feasibility Studies Female Implant Cardiology and Cardiovascular Medicine business |
| Popis: | Aims To describe a technique of simultaneous aortography and balloon aortic valvuloplasty (BAV) before transcatheter aortic valve replacement (TAVR), and to show how this technique affected TAVR prosthesis selection and procedural outcomes. Methods and results One hundred and eleven patients underwent simultaneous contrast injection during valvuloplasty pre-TAVR to confirm the indication for prosthesis size provided by non-invasive imaging studies. A successful injection was achieved in 95 patients (85.5%). No events occurred during simultaneous BAV and contrast injection. In 12 (10.8%) patients the prosthesis size implanted was different from the recommendations provided by the non-invasive imaging examinations. In nine of these cases (75.0%) it was decided to implant a larger prosthesis than that originally suggested, in the remaining three cases (25.0%) a smaller valve was implanted. Device success in this particular subset of patients was 100%. Overall device success was 92.8%. Post-procedural moderate paravalvular regurgitation was reported in 5.4% of patients. Conclusions In patients with severe aortic valve stenosis, a technique of simultaneous aortography and balloon valvuloplasty as an adjunct to non-invasive imaging modalities for transcatheter prosthesis selection is feasible, and leads to a change in TAVR strategy in a modest number of patients. Larger studies are necessary to confirm these findings, and to assess whether this method is capable of enhancing the safety of the TAVR procedure. |
| Databáze: | OpenAIRE |
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