title: Reappraisal of percutaneous aortic balloon valvuloplasty as a preliminary treatment strategy in the transcatheter aortic valve implantation era.
abstract: OBJECTIVE
  To assess the results of percutaneous aortic balloon valvuloplasty (PABV) as a potential bridge to further intervention in patients referred for transcatheter aortic valve implantation (TAVI).
  
  
  RESULTS
  Two hundred and fifty-three patients referred for TAVI were studied: 41 (16%) were considered transiently unsuitable for either aortic valve replacement (AVR) or TAVI and underwent PABV as a bridge to intervention. In the others, primary TAVI or AVR was performed in 140 cases, and medical therapy alone in 72.The overall population was at high risk: 82 ± 8 years, logistic EuroSCORE: 28 ± 16%, STS score: 16 ± 10%. There was no PABV-related death. Twenty-three patients underwent secondary TAVI (n=19) or AVR (n=4), 18 did not undergo further intervention. One and two year survival rates were respectively 94 ± 5% and 85 ± 10% after bridge PABV, and 33 ± 11 and 6 ± 5% after PABV alone. There was no difference in survival between the primary TAVI / AVR and bridge PABV (p=0.08), and between medical treatment and PABV alone (p=0.36).
  
  
  CONCLUSIONS
  In high-risk patients with aortic stenosis and temporary contraindications to AVR or TAVI, PABV may be used as a bridge to intervention with good mid-term outcomes. In others, PABV can be safely used but is associated with a poor outcome.
authors.affiliation: Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard Hospital, Paris, France.
authors.forename: Claire-Marie
authors.initials: CM
authors.lastname: Tissot
authors.forename: David
authors.initials: D
authors.lastname: Attias
authors.forename: Dominique
authors.initials: D
authors.lastname: Himbert
authors.forename: Gregory
authors.initials: G
authors.lastname: Ducrocq
authors.forename: Bernard
authors.initials: B
authors.lastname: Iung
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Dilly
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Juliard
authors.forename: Laurent
authors.initials: L
authors.lastname: Lepage
authors.forename: Delphine
authors.initials: D
authors.lastname: Détaint
authors.forename: David
authors.initials: D
authors.lastname: Messika-Zeitoun
authors.forename: Patrick
authors.initials: P
authors.lastname: Nataf
authors.forename: Alec
authors.initials: A
authors.lastname: Vahanian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006328:Cardiac Catheterization; D002404:Catheterization / Q000379:methods*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D015996:Survival Rate; D016277:Ventricular Function, Left