Safety and feasibility of retrograde INOUE-BALLOON for balloon aortic valvuloplasty without rapid ventricular pacing during transcatheter aortic valve replacement
| Autor: | Ryo Ninomiya, Atsushi Tashiro, Fumiaki Takahashi, Yoshihiro Morino, Yu Ishikawa, Michiko Yoshizawa, Tetsuya Fusazaki, Akiko Kumagai, Yorihiko Koeda, Hajime Kin, Masaru Ishida |
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| Rok vydání: | 2021 |
| Předmět: |
Balloon Valvuloplasty
Male Aortic valve medicine.medical_specialty Transcatheter aortic medicine.medical_treatment Hemodynamics 030204 cardiovascular system & hematology Balloon Transcatheter Aortic Valve Replacement 03 medical and health sciences 0302 clinical medicine Valve replacement Internal medicine Clinical endpoint Humans Medicine Radiology Nuclear Medicine and imaging 030212 general & internal medicine Aged Aged 80 and over medicine.diagnostic_test business.industry Interventional radiology Aortic Valve Stenosis General Medicine Aortic valvuloplasty Treatment Outcome medicine.anatomical_structure Aortic Valve Cardiology Feasibility Studies Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiovascular Intervention and Therapeutics. 37:372-380 |
| ISSN: | 1868-4297 1868-4300 |
| DOI: | 10.1007/s12928-021-00789-0 |
| Popis: | Rapid ventricular pacing (RVP) is commonly employed during transcatheter aortic valve replacement (TAVR); however, frequent TAVR is associated with worse prognoses. The retrograde INOUE-BALLOON® (IB) allows balloon aortic valvuloplasty (BAV) without RVP. The aim of this study was to evaluate the feasibility of retrograde IB for TAVR preparation. The study population included 178 consecutive patients (mean age, 84 ± 5 years; male, 47%) who underwent retrograde BAV before prosthetic valve replacement via the transfemoral approach. Patients were divided into a retrograde IB group without RVP (n = 74) and a conventional balloon (CB) group with RVP (n = 104). The primary endpoint was prolonged hypotension after BAV (reduced systolic pressure p = 0.011). Balloons were able to penetrate and expand the aortic valve in both groups. RVP was used less for total TAVR in the IB group compared with the CB group. The aortic valve area-index after BAV was not significantly different between the two groups (0.72 ± 0.14 cm2/m2 vs. 0.71 ± 0.12 cm2/m2; p = 0.856). Multivariate analysis demonstrated that IB use was associated with avoidance of prolonged hypotension (OR, 0.27 [0.059–0.952]; p = 0.041). In conclusion, BAV using retrograde IB without RVP is both safe and feasible. More stable hemodynamics were achieved using retrograde IB by avoiding RVP during TAVR. |
| Databáze: | OpenAIRE |
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