RT Journal Article
SR Electronic
T1 Clinical outcomes following balloon aortic valvuloplasty
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e001330
DO 10.1136/openhrt-2020-001330
VO 7
IS 2
A1 Anda Bularga
A1 Rong Bing
A1 Anoop SV Shah
A1 Philip D Adamson
A1 Miles Behan
A1 David E Newby
A1 Andrew Flapan
A1 Neal Uren
A1 Nick Cruden
YR 2020
UL http://openheart.bmj.com/content/7/2/e001330.abstract
AB Background Balloon aortic valvuloplasty (BAV) remains a treatment option for the selected patients with severe aortic stenosis. We examined clinical outcomes and predictors of prognosis in patients undergoing BAV for severe aortic stenosis.Methods We identified all patients undergoing BAV from January 2010 to March 2018 (n=167) at a single transcatheter aortic valve implantation (TAVI) centre. Patient demographics, investigations, subsequent interventions and clinical outcomes were obtained from electronic health records.Results Patients undergoing BAV were elderly (median age 80, IQR 73–86 years) and half (n=87, 52%) were male. All-cause mortality at 30 days and 12 months was 11% and 43%, respectively. Reduce ejection fraction (EF 30%–50%: HR 1.76, 95% CI 1.05 to 2.94; EF <30%: HR 1.90, 95% CI 1.12 to 3.20) was the only independent predictor at baseline of overall mortality. Median survival was 212 (IQR 54–490) days from the index procedure. Mortality at 1 year was lowest in patients who subsequently underwent TAVI or SAVR but high among those who had no further interventions or those who had a repeat BAV (14%, 19%, 60%, 89% respectively, log-rank p<0.001).Conclusion BAV as a bridge to definitive aortic valve intervention in carefully selected patients offers acceptable outcomes. These contemporary observational findings demonstrate the ongoing potential utility of BAV in the TAVI era.