title: Balloon-Expandable Transcatheter Aortic Valves Can Be Successfully and Safely Implanted Transfemorally Without Balloon Valvuloplasty.
abstract: OBJECTIVE
  To assess the necessity for balloon aortic valvuloplasty (BAV) during transfemoral transcatheter aortic valve implantation (TAVI) when using balloon-expandable valves.
  
  
  BACKGROUND
  BAV is a usual part of TAVI procedures, prior to valve implantation. However, the benefits and necessity of this are unknown and recent evidence in self-expanding valves suggests it may not be necessary.
  
  
  METHODS
  Retrospective single-center study of 154 patients undergoing first-time, transfemoral TAVI for native aortic valve stenosis, with (N = 76), and without (N = 78), BAV as part of the procedure. Data collected included demographic, procedural, and outcome data.
  
  
  RESULTS
  BAV did not alter VARC-2 defined procedural success or early safety compared to not performing a BAV, including mortality, degree of aortic regurgitation, or need for post-TAVI balloon dilatation, although there was a strong trend to reduced stroke when not performing a BAV. There was a significantly reduced procedural time (P = 0.01) and fluoroscopic time (P < 0.001) without performing a BAV. There were no differences in cerebral embolization (solid, gaseous, or total emboli) noted between the 2 groups, as measured on transcranial doppler (TCD).
  
  
  CONCLUSIONS
  TAVI can be effectively and safely performed without a BAV and this results in reduced procedural and fluoroscopic times, although embolization to the brain is not reduced. There is a trend toward reduced stroke risk. (J Interven Cardiol 2016;29:319-324).
authors.affiliation: Department of Cardiology, The Heart Hospital, University College London Hospitals, London, United Kingdom.
authors.forename: Suneil K
authors.initials: SK
authors.lastname: Aggarwal
authors.affiliation: Department of Cardiology, The Heart Hospital, University College London Hospitals, London, United Kingdom.
authors.forename: Nicola
authors.initials: N
authors.lastname: Delahunty
authors.affiliation: Department of Cardiology, The Heart Hospital, University College London Hospitals, London, United Kingdom.
authors.forename: Bethany
authors.initials: B
authors.lastname: Wong
authors.affiliation: Department of Cardiology, The Heart Hospital, University College London Hospitals, London, United Kingdom.
authors.forename: Asad N
authors.initials: AN
authors.lastname: Tamimi
authors.affiliation: Department of Cardiology, The Heart Hospital, University College London Hospitals, London, United Kingdom.
authors.forename: Markus
authors.initials: M
authors.lastname: Reinthaler
authors.affiliation: Department of Cardiology, The Heart Hospital, University College London Hospitals, London, United Kingdom.
authors.forename: Mun-Hong
authors.initials: MH
authors.lastname: Cheang
authors.affiliation: Department of Cardiothoracic Surgery, The Heart Hospital, University College London Hospitals, London, United Kingdom.
authors.forename: Neil
authors.initials: N
authors.lastname: Roberts
authors.affiliation: Department of Cardiothoracic Surgery, The Heart Hospital, University College London Hospitals, London, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Yap
authors.affiliation: Department of Cardiology, The Heart Hospital, University College London Hospitals, London, United Kingdom.
authors.forename: Muhiddin
authors.initials: M
authors.lastname: Ozkor
authors.affiliation: Department of Cardiology, The Heart Hospital, University College London Hospitals, London, United Kingdom.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mullen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D063126:Balloon Valvuloplasty / Q000009:adverse effects / Q000379:methods*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome