COMPARATIVE EFFECTIVENESS OF BALLOON AORTIC VALVULOPLASTY WITH NON-COMPLIANT AND COMPLIANT BALLOONS IN THE ERA OF TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR) AND RADIAL ACCESS

Document Type

Conference Proceeding

Publication Date

4-1-2025

Publication Title

J Am Coll Cardiol

Keywords

aortic regurgitation, aortic valve repair, balloon, bleeding, cerebrovascular accident, chi square distribution, clinical outcome, comparative effectiveness, complication, conference abstract, controlled study, device comparison, heart block, heart failure, hemodynamics, hospitalization, human, hypotension, major clinical study, middle aged, transcatheter aortic valve implantation, valve-in-valve transcatheter aortic valve implantation

Abstract

Background: Balloon aortic valvuloplasty (BAV) is increasingly used in the TAVR era, and radial access is now feasible. We investigate the comparative effectiveness of compliant and non-compliant balloons for BAV Methods 253 Patients undergoing BAV at a tertiary center in USA from 2021-2024 were evaluated. Changes in peak gradient and aortic insufficiency, adoption of radial access, and number of balloon inflation; periprocedural VARC-III vascular and bleeding events, and nonaccess events including heart block, stroke, hypotension, severe AI and periprocedural death; and 30-day composite of death, heart failure hospitalization, stroke, and discharge failure was assessed. Chi-square test, Wilcoxon ranksum test, and Kaplan Meier estimates with logrank test were used for dichotomous variables, non-parametric continuous variables, and time-to-event, respectively Results Compliant and non-compliant balloons were used in 58.1 and 41.9% of cases, respectively. There was no significant difference in drop in gradient, increase in AI, number of balloon inflation. (A-B). Radial access use was more common with compliant balloons, 53.6% vs 27.2%(p<0.001) (B). Periprocedural and 30-day event rates were similar (all p>0.05) with numerically more non-access events with noncompliant balloons (C-D) Conclusion In the contemporary era, BAV with noncompliant and compliant balloons have similar hemodynamic and clinical outcomes and a higher adoption rate of radial access with compliant balloons [Formula presented]

Volume

85

Issue

12

First Page

852

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