Postdilatation for treatment of perivalvular aortic regurgitation after transcatheter aortic valve implantation

Catheter Cardiovasc Interv. 2014 Jan 1;83(1):E112-8. doi: 10.1002/ccd.25173. Epub 2013 Sep 30.

Abstract

Objectives: The study is made to describe the efficacy and safety of balloon postdilatation (BPD) for the treatment of residual aortic regurgitation (RAoR) after transcatheter aortic valve implantation (TAVI).

Methods and results: A single-center observational study is made with 157 consecutive patients accepted to TAVI. The patients were divided into two groups (no BPD-period and BPD-period). Before BPD, RAoR ≥ 2 was seen in 25% of the patients in group 1 and in 29% of the patients in group 2 (P ≥ 0.593). BPD was carried out in 95% (n = 21) of the patients in group 2 with RAoR ≥ 2. Regurgitation improved one grade in 68% of the cases (n = 15), 2 grades in 14% (n = 3), and remained without change in 18% (n = 4). RAoR < 2 was achieved in 91% (n = 73) of the patients in group 2 versus 75% (n = 58) in group 1 (RR = 0.35, 95% CI 0.16-0.80, P = 0.013). We recorded no aortic ring ruptures, damage to the device or displacements. Slight central regurgitation not present before BPD was registered in one case.

Conclusions: BPD offers a very good safety profile and reduces RAoR in a large percentage of cases. BPD should be considered for the treatment of moderate to severe RAoR following TAVI.

Keywords: TAVI; aortic valve regurgitation; aortic valve stenosis; balloon dilatation.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve Insufficiency / diagnosis
  • Aortic Valve Insufficiency / etiology
  • Aortic Valve Insufficiency / therapy*
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / therapy*
  • Balloon Valvuloplasty* / adverse effects
  • Cardiac Catheterization / adverse effects*
  • Cardiac Catheterization / instrumentation
  • Female
  • Heart Valve Prosthesis
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Heart Valve Prosthesis Implantation / instrumentation
  • Heart Valve Prosthesis Implantation / methods
  • Humans
  • Male
  • Prosthesis Design
  • Severity of Illness Index
  • Spain
  • Treatment Outcome