title: Balloon aortic valvuloplasty (BAV) as a bridge to aortic valve replacement in cancer patients who require urgent non-cardiac surgery.
abstract: BACKGROUND
  Balloon aortic valvuloplasty (BAV) is a percutaneous treatment option for severe, symptomatic aortic stenosis. Due to early restenosis and failure to improve long term survival, BAV is considered a palliative measure in patients who are not suitable for open heart surgery due to increased perioperative risk. BAV can be used also as a bridge to surgical or transcatheter aortic valve implantation (TAVI) in haemodinamically unstable patients or in patients who require urgent major non-cardiac surgery.
  
  
  METHODS
  We reported on 6 oncologic patients with severe aortic stenosis that required a major abdominal and gynaecological surgery. In 5 cases we performed BAV procedure alone; in one patient with concomitant coronary artery disease we combined BAV and percutaneous coronary intervention (PCI).
  
  
  RESULTS
  With angioplasty and BAV we achieved a good coronary artery flow and an increase in aortic valve area without any periprocedural complications. After the successful procedure, we observed a hemodynamic and symptomatic improvement. As a consequence the operative risk for non-cardiac surgery decreased and the surgical treatment of cancer was done without complications in all the 6 cases.
  
  
  CONCLUSIONS
  BAV can be utilized as a part of a complex therapy in severe aortic stenosis aimed to improve the quality of life, decrease the surgical risk for major non-cardiac surgery or as a bridge to surgical or transcatheter aortic valve implantation.
authors.affiliation: Department of Cardiology, Division of Internal Medicine, University Medical Centre Ljubljana, Slovenia.
authors.forename: Polonca
authors.initials: P
authors.lastname: Kogoj
authors.affiliation: Institute of Oncology Ljubljana, Ljubljana, Slovenia.
authors.forename: Rok
authors.initials: R
authors.lastname: Devjak
authors.affiliation: Department of Cardiology, Division of Internal Medicine, University Medical Centre Ljubljana, Slovenia.
authors.forename: Matjaz
authors.initials: M
authors.lastname: Bunc
keywords: angioplasty; aortic valve stenosis; balloon dilatation; comorbidities; coronary artery disease; elderly; heart valve prosthesis implantation