Balloon aortic valvuloplasty through the novel transradial technique

Horacio A. Medina De Chazal, Ignacio M. Seropian, Francisco Romeo, Juan G. Chiabrando, Juan Valleraleigh, Daniel H. Berrocal, Carla R. Agatiello

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

BACKGROUND: Balloon aortic valvuloplasty (BAV) has been typically performed through a femoral approach thus increasing the risk of bleeding and access site-related vascular complications. The aim of this study was to describe the safety and efficacy of transradial aortic valve valvuloplasty (TRBAV). METHODS: The present research is a retrospective, single-center study including patients undergoing TRBAV (October 2019-July 2020). BAV was performed using 18-25 mm balloons through an 8-10 French (F) radial sheath. Successful BAV was defined as >50% reduction in peak-to-peak gradient (efficacy endpoint). Procedural complications, including radial artery occlusion (RAQ) at follow-up were evaluated (safety endpoint). RESULTS: Twenty-four patients underwent TRBAV were included, aged 81 (73-85) years, 70% males, EuroScorell 3.1 (2.1-5.5). Aortic valve gradient was significantly reduced (pre-50±24 vs. 18.7±13 mmHg post, P<0.001), and 91% had successful BAV. Mean gradient drop was 31.4±16.8 mmHg. One patient (4%) required cross-over to femoral access for severe vasospasm and was excluded from the analysis. Most used sheaths were 8F (46%) and 9F (37%), mostly for 20 mm (50%) and 23 mm (38%) balloons. There were neither major procedural complications (neither balloon entrapment nor compartmental syndrome) nor minor complications (any access-site bleeding). RAO was observed in 2 patients (8%), both asymptomatic. CONCLUSIONS: TRBAV was safe, feasible, and efficacious with a small rate of conversion and RAO, suggesting reproducibility of this novel technique. TRBAV may represent an alternative to femoral access in selected patients although larger studies are warranted.

Original languageEnglish
Pages (from-to)458-463
Number of pages6
JournalMinerva Cardiology and Angiology
Volume69
Issue number4
DOIs
StatePublished - Aug 2021

Keywords

  • Aorta
  • Aortic valve stenosis
  • Balloon valvuloplasty

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