title: Outcomes of Patients Undergoing Balloon Aortic Valvuloplasty in the TAVI Era: A Multicenter Registry.
abstract: BACKGROUND
  Few clinical data about indications and prognoses of patients undergoing balloon aortic valvuloplasty (BAV) in the transcatheter aortic valve implantation (TAVI) era have been reported.
  
  
  METHODS
  Data from all consecutive patients undergoing BAV in seven European centers from 2006 to 2013 were collected. Acute results and long-term outcomes were assessed.
  
  
  RESULTS
  A total of 811 patients aged 82 ± 9 years were included; 416 patients (51%) underwent BAV as palliative destination therapy, 320 patients (40%) as bridge to TAVI, and 75 patients (9%) as bridge to surgical aortic valve replacement (SAVR). Patients undergoing BAV as destination therapy had a higher risk profile (logistic EuroSCORE, 20 ± 17 vs 22 ± 14 vs 11 ± 8, respectively; P<.001). Post procedure, peak gradient decreased from 87 ± 22 mm Hg to 66 ± 22 mm Hg (P<.001) and aortic valve area increased from 0.61 ± 0.2 cm2 to 0.8 ± 0.2 cm2 (P<.001). At 30 days, the all-cause death rate (6.5% vs 6.2% vs 7.4%, respectively; P=.56) and the rate of life-threatening and major bleedings (8.0% vs 5.7% vs 6.0%, respectively) did not differ between groups. After a mean follow-up of 318 days (range, 116-500 days), rates of all-cause death were similar (30% vs 34% vs 31%, respectively; P>.99), although patients undergoing BAV as bridge to SAVR showed a lower cardiovascular death rate (11% vs 11% vs 3%, respectively; P=.04).
  
  
  CONCLUSIONS
  In the TAVI era, BAV may represent a reasonable option for patients with severe aortic stenosis and temporary contraindications to definite therapy. Given the mortality rates at 30 days, patients should be carefully selected, while events at follow-up are deeply influenced by the decision of whether or not subsequent interventions are performed.
authors.forename: Claudio
authors.initials: C
authors.lastname: Moretti
authors.forename: Sujay
authors.initials: S
authors.lastname: Chandran
authors.forename: Paul-Louis
authors.initials: PL
authors.lastname: Vervueren
authors.forename: Fabrizio
authors.initials: F
authors.lastname: D'Ascenzo
authors.forename: Marco
authors.initials: M
authors.lastname: Barbanti
authors.forename: Roshan
authors.initials: R
authors.lastname: Weerackody
authors.forename: Giacomo
authors.initials: G
authors.lastname: Boccuzzi
authors.forename: Dae-Hyun
authors.initials: DH
authors.lastname: Lee
authors.forename: Jose
authors.initials: J
authors.lastname: de la Torre Hernandez
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Omedè
authors.forename: Vincent
authors.initials: V
authors.lastname: Nijenhuis
authors.forename: Norris
authors.initials: N
authors.lastname: Igbineweka
authors.forename: Patrick
authors.initials: P
authors.lastname: Lim
authors.lastname: ten Berg
authors.forename: Didier
authors.initials: D
authors.lastname: Carriè
authors.forename: David
authors.initials: D
authors.lastname: Hildick-Smith
authors.forename: Simona
authors.initials: S
authors.lastname: Gulino
authors.forename: Stefano
authors.initials: S
authors.lastname: Cannata
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gargiulo
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.forename: Federico
authors.initials: F
authors.lastname: Conrotto
authors.forename: Ilaria
authors.initials: I
authors.lastname: Meynet
authors.forename: Giorgio
authors.initials: G
authors.lastname: Quadri
authors.forename: Ludovica
authors.initials: L
authors.lastname: Marangoni
authors.affiliation: Division of Cardiology, Città Della Salute e Della Scienza, Turin, Italy; Cardiology Department, Assuit University Hospital, Assuit, Egypt. esmaeil.salma@gmail.com; www.cardiogroup.org.
authors.forename: Salma
authors.initials: S
authors.lastname: Taha
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Biondi-Zoccai
authors.forename: Stefano
authors.initials: S
authors.lastname: Salizzoni
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Marra
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000628:therapy*; D063126:Balloon Valvuloplasty / Q000379:methods*; D006328:Cardiac Catheterization / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome