Abstract

Near-abolition of rheumatic heart disease in developed countries has transformed the demography of aortic stenosis (AS), which today results primarily from age-associated calcific degeneration. In the absence of aortic valve replacement (AVR), symptomatic severe AS portends a high risk of mortality that has remained largely unchanged despite advances in medical therapy. This chapter provides a comprehensive reassessment of balloon aortic valvuloplasty (BAV) and large-bore arterial access for adult patients with calcific AS in the era of transcatheter aortic valve replacement (TAVR). BAV, like its descendant TAVR, can be accomplished either via an anterograde or retrograde approach, described as the direction in which the balloon crosses the aortic valve relative to the direction of blood flow. With effective percutaneous access and closure, a patient can be mobilized within hours of BAV, or even TAVR, with little to show other than a small incision and a bandage.

Original languageEnglish
Title of host publicationInterventional Cardiology
Subtitle of host publicationPrinciples and Practice
Publisherwiley
Pages546-557
Number of pages12
ISBN (Electronic)9781118983652
ISBN (Print)9781118976036
DOIs
StatePublished - 21 Nov 2016

Keywords

  • Age-associated calcific degeneration
  • Aortic stenosis
  • Aortic valve replacement
  • Balloon aortic valvuloplasty
  • Large-bore percutaneous arterial access
  • Medical therapy
  • Rheumatic heart disease
  • Transcatheter aortic valve replacement

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