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Predilation in Transcatheter Aortic Valve Implantation

  • Alexander Sedaghat
  • Eberhard Grube
  • Jan-Malte Sinning
Chapter

Abstract

The need for predilation in transcatheter aortic valve implantation (TAVI) is a matter of ongoing debate. Performed under rapid overdrive pacing with the use of non-compliant or semi-compliant balloons, predilation aims at increasing aortic valve area to facilitate passage of the delivery catheter across the native aortic valve, to facilitate prosthesis positioning, and to allow adequate expansion of the transcatheter heart valve (THV). Potential complications of predilation are manifold and include hemodynamic deterioration, severe aortic regurgitation, cardiac perforation, aortic (annulus) rupture, coronary obstruction, stroke, and conduction disturbances. The clinical evidence for the routine use of predilation is limited mainly to retrospective studies and meta-analyses, most of which suggest safety and feasibility of “direct TAVI” in selected patients. Until the results of ongoing randomized trials are available, patient characteristics including aortic valve morphology and amount of calcification should lead the decision whether to use predilation in an individual TAVI patient.

Keywords

TAVI Predilation Direct TAVI Balloon aortic valvuloplasty 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Alexander Sedaghat
    • 1
  • Eberhard Grube
    • 1
  • Jan-Malte Sinning
    • 1
  1. 1.Heart Center Bonn, University Hospital BonnBonnGermany

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