title: Impact of balloon aortic valvuloplasty on transcatheter aortic valve implantation with self-expandable valve.
abstract: Balloon aortic valvuloplasty (BAV) has been used prior to valve implantation of a self-expandable valve as part of the transcatheter aortic valve implantation (TAVI) procedure. We aimed to evaluate the impact of BAV prior to TAVI.
  
  
  
  We retrospectively studied 203 consecutive patients who were treated either with (pre-BAV-TAVI group) or without BAV (D-TAVI group). Implantation depth (ID) was angiographically measured at non-coronary cusp (NCC) and left coronary cusp (LCC) at: the starting point (stage-1), before (stage-2), and after (stage-3) final bioprosthesis release. Paravalvular regurgitation (PVR) and 1-year clinical follow-up were recorded.
  
  
  
  Overall, from stage-1 to stage-3, prosthesis migrated toward the left ventricle, in both cusps and groups. At NCC a forward migration was observed from stage-1 to stage-2 in both groups (p<0.001). In the pre-BAV-TAVI group only, at NCC, an upward migration decreased the ID from stage-2 to stage-3 (p=0.022). PVR ≥grade 2, immediately after expansion was more frequently observed in pre-BAV-TAVI group (41% vs 22%, respectively; p=0.024). However, PVR was similar at discharge. Clinical parameters were comparable between the two groups.
  
  
  
  The use of BAV prior to TAVI may have an impact on device final position, but not on short- and long-term clinical outcome.
authors.affiliation: 1st Department of Cardiology, National and Kapodistrian University of Athens, Medical School, General Hospital of Athens "Hippokration", Greece; The Ohio State University, Wexner Medical Center in Columbus, Columbus, OH, USA.
authors.forename: Manolis
authors.initials: M
authors.lastname: Vavuranakis
authors.affiliation: 1st Department of Cardiology, National and Kapodistrian University of Athens, Medical School, General Hospital of Athens "Hippokration", Greece. Electronic address: marialav12@hotmail.com.
authors.forename: Maria
authors.initials: M
authors.lastname: Lavda
authors.affiliation: 1st Department of Cardiology, National and Kapodistrian University of Athens, Medical School, General Hospital of Athens "Hippokration", Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Vrachatis
authors.affiliation: 1st Department of Cardiology, National and Kapodistrian University of Athens, Medical School, General Hospital of Athens "Hippokration", Greece.
authors.forename: Theodore G
authors.initials: TG
authors.lastname: Papaioannou
authors.affiliation: 1st Department of Cardiology, National and Kapodistrian University of Athens, Medical School, General Hospital of Athens "Hippokration", Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kalogeras
authors.affiliation: 1st Department of Cardiology, National and Kapodistrian University of Athens, Medical School, General Hospital of Athens "Hippokration", Greece.
authors.forename: Angelos-Michail
authors.initials: AM
authors.lastname: Kolokathis
authors.affiliation: 1st Department of Cardiology, National and Kapodistrian University of Athens, Medical School, General Hospital of Athens "Hippokration", Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Kariori
authors.affiliation: The Ohio State University, Wexner Medical Center in Columbus, Columbus, OH, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Lilly
authors.affiliation: 1st Department of Cardiology, National and Kapodistrian University of Athens, Medical School, General Hospital of Athens "Hippokration", Greece; Brigham and Women's Hospital, Harvard Medical School, Cardiovascular Division, Boston, MA, USA.
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Siasos
authors.affiliation: 1st Department of Cardiology, National and Kapodistrian University of Athens, Medical School, General Hospital of Athens "Hippokration", Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Oikonomou
authors.affiliation: 1st Department of Cardiology, National and Kapodistrian University of Athens, Medical School, General Hospital of Athens "Hippokration", Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Toutouzas
authors.affiliation: Regional Cancer Hospital, Department of Radiology, Agios Savvas, Athens, Greece.
authors.forename: Myrsini
authors.initials: M
authors.lastname: Stasinopoulou
authors.affiliation: Regional Cancer Hospital, Department of Radiology, Agios Savvas, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Deliveliotis
authors.affiliation: 1st Department of Cardiology, National and Kapodistrian University of Athens, Medical School, General Hospital of Athens "Hippokration", Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tousoulis
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery*; D063126:Balloon Valvuloplasty / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents; D065467:Transcatheter Aortic Valve Replacement / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome
keywords: Aortic stenosis; Balloon aortic valvuloplasty; Implantation depth; Paravalvular regurgitation; Transcatheter aortic valve implantation