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Feasibility and safety of transradial balloon aortic valvuloplasty in patients with severe aortic stenosis

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Abstract

Balloon aortic valvuloplasty (BAV) was developed as a technique to treat aortic stenosis (AS) and is associated with significant improvements in aortic valve area and trans-aortic valve gradient in the early and immediate periods after the procedure. BAV is commonly performed using a trans-femoral retrograde approach; however, trans-femoral access is associated with frequent access-site bleeding. Among 146 patients with symptomatic severe AS who were treated with BAV in our institution, 123 patients received BAV treatment via a trans-radial approach using a 7-Fr Glidesheath. The balloon size was 16–20 mm for all patients. Echocardiograms were obtained before and after BAV. Patients who received BAV alone (n = 119) were followed up for 3 months, and major adverse events (stroke, re-hospitalization for heart failure, and death) and procedural complications were recorded. At post-procedural echocardiography, the mean trans-valvular gradient (49.7 ± 21.5–42.5 ± 17.6 mmHg; p < 0.0001) was reduced significantly. All patients in this study did not die or require valve surgery within the first 7 days after BAV. Successful BAV was obtained in 45.6% of the patients. No patients had severe aortic insufficiency or BAV access-site bleeding. Three patients died suddenly and 4 patients were readmitted for heart failure. Trans-radial BAV is safe and may be useful as a bridging therapy for trans-catheter aortic valve replacement or surgical aortic valve replacement.

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Author notes

  1. Yugo Minamimoto and Kiyoshi Hibi contributed equally to this work.

Authors and Affiliations

  1. Division of Cardiology, Yokohama City University Medical Center, 4-57, Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan

    Yugo Minamimoto, Kiyoshi Hibi, Jin Kirigaya, Hironori Takahashi, Kensuke Matsushita, Noriaki Iwahashi, Yasushi Matsuzawa, Nobuhiko Maejima, Masami Kosuge, Toshiaki Ebina & Kazuo Kimura

  2. Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Yugo Minamimoto, Teruyasu Sugano, Toshiyuki Ishikawa, Kouichi Tamura & Kazuo Kimura

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  1. Yugo Minamimoto
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Correspondence to Kiyoshi Hibi.

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Minamimoto, Y., Hibi, K., Kirigaya, J. et al. Feasibility and safety of transradial balloon aortic valvuloplasty in patients with severe aortic stenosis. Cardiovasc Interv and Ther 37, 558–565 (2022). https://doi.org/10.1007/s12928-021-00825-z

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