title: Impella-assisted balloon aortic valvuloplasty as a bridge to transcatheter aortic valve replacement: non-contrast approach.
abstract: Patients with severe aortic stenosis (AS) and left ventricular dysfunction are susceptible to hemodynamic decompensation due to limited myocardial reserve. Recent reports have suggested a role for hemodynamic assist devices such as the Impella or TandemHeart for improved in-hospital outcomes. However, the use of iodinated contrast during this vulnerable period poses a high risk for the development of contrast-induced nephropathy. A strategic approach is described for the treatment of high-risk patients with severe AS and cardiogenic shock, utilizing Impella-assisted balloon aortic valvuloplasty (BAV), without the administration of iodinated contrast as a bridge to transcatheter aortic valve replacement.
authors.forename: Vikas
authors.initials: V
authors.lastname: Singh
authors.forename: Alon
authors.initials: A
authors.lastname: Yarkoni
authors.forename: Cesia
authors.initials: C
authors.lastname: Gallegos
authors.forename: William W
authors.initials: WW
authors.lastname: O'Neill
mesh_terms: D000368:Aged; D000465:Algorithms; D001024:Aortic Valve Stenosis / Q000150:complications / Q000628:therapy*; D063126:Balloon Valvuloplasty / Q000379:methods*; D004867:Equipment Design; D019918:Heart Valve Prosthesis Implantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D012770:Shock, Cardiogenic / Q000150:complications / Q000628:therapy*