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Percutaneous balloon aortic valvuloplasty in the era of transcatheter aortic valve implantation: a narrative review
  1. Thomas R Keeble1,2,
  2. Arif Khokhar2,3,
  3. Mohammed Majid Akhtar4,
  4. Anthony Mathur4,
  5. Roshan Weerackody4 and
  6. Simon Kennon4
  1. 1Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK
  2. 2Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, UK
  3. 3Department of Cardiology, Royal Brompton & Harefield NHS Trust, London, UK
  4. 4Department of Cardiology, Barts’ Heart Centre, St. Bartholomews’ Hospital, London, UK
  1. Correspondence to Dr Simon Kennon; Simon.kennon{at}


The role of percutaneous balloon aortic valvuloplasty (BAV) in the management of severe symptomatic aortic stenosis has come under the spotlight following the development of the transcatheter aortic valve implantation (TAVI) technique. Previous indications for BAV were limited to symptom palliation and as a bridge to definitive therapy for patients undergoing conventional surgical aortic valve replacement (AVR). In the TAVI era, BAV may also be undertaken to assess the ‘therapeutic response’ of a reduction in aortic gradient in borderline patients often with multiple comorbidities, to assess symptomatic improvement prior to consideration of definitive TAVI intervention. This narrative review aims to update the reader on the current indications and practical techniques involved in undertaking a BAV procedure. In addition, a summary of the haemodynamic and clinical outcomes, as well as the frequently encountered procedural complications is presented for BAV procedures conducted during both the pre-TAVI and post-TAVI era.


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  • Contributors TRK and SK conceived the project. TRK wrote the first draft with AK, MMA, AM, RW and SK involved in revisions.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.