Outcome of Patients Undergoing Transcatheter Aortic Valve Implantation after Prior Balloon Aortic Valvuloplasty

Arturo Giordano, Nicola Corcione, Paolo Ferraro, Francesco Bedogni, Luca Testa, Gennaro Sardella, Massimo Mancone, Fabrizio Tomai, Giovanni De Persio, Alessandro Iadanza, Giacomo Frati, Giuseppe Biondi-Zoccai

Research output: Contribution to journalArticle

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Abstract

OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is an effective treatment for severe aortic stenosis. Yet, balloon aortic valvuloplasty (BAV) is still occasionally offered to apparently inoperable patients as bridge or destination therapy, with some eventually receiving TAVI. We aimed to determine whether prior BAV would unfavorably impact TAVI. METHODS: The RISPEVA dataset was analyzed to compare the outcomes of non-BAV subjects undergoing TAVI vs those with prior BAV. Outcomes of interest were procedural results, hospital stay, and in-hospital outcomes, including major adverse events. Unadjusted and propensity-matched analyses were performed. RESULTS: A total of 1683 patients were included (1541 [91.6%] non-BAV and 142 [8.4%] prior BAV). Device success, procedural success, major adverse events and their individual components were all similar in the two groups, in both unadjusted and propensity-matched analyses. However, non-BAV patients had significantly shorter intensive/coronary care unit stay (8.1 ± 23.0 days vs 13.4 ± 35.2 days; P≤.03) and total hospital stay (12.4 ± 22.1 days vs 17.2 ± 32.7 days; P≤.02). Similar findings were obtained even in the propensity-matched groups (6.3 ± 11.9 days vs 13.6 ± 35.5 days [P≤.05] and 10.5 ± 13.8 days vs 17.4 ± 33.1 days [P≤.03], respectively). No significant interaction was found between device type and prior BAV status. CONCLUSION: BAV continues to offer a palliative solution to patients with unclear or poor prognosis and deemed at too high risk for emergent TAVI or surgery. Subjects undergoing BAV and surviving the post-BAV period can undergo TAVI without a significantly increased risk of in-hospital adverse events in comparison with non-BAV patients.

Original languageEnglish
Pages (from-to)380-385
Number of pages6
JournalJournal of Invasive Cardiology
Volume30
Issue number10
Publication statusPublished - Oct 1 2018

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Balloon Valvuloplasty
Length of Stay
Coronary Care Units
Equipment and Supplies
Transcatheter Aortic Valve Replacement
Aortic Valve Stenosis
Intensive Care Units
Research Design

Keywords

  • Balloon aortic valvuloplasty
  • Transcatheter aortic valve implantation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Outcome of Patients Undergoing Transcatheter Aortic Valve Implantation after Prior Balloon Aortic Valvuloplasty. / Giordano, Arturo; Corcione, Nicola; Ferraro, Paolo; Bedogni, Francesco; Testa, Luca; Sardella, Gennaro; Mancone, Massimo; Tomai, Fabrizio; De Persio, Giovanni; Iadanza, Alessandro; Frati, Giacomo; Biondi-Zoccai, Giuseppe.

In: Journal of Invasive Cardiology, Vol. 30, No. 10, 01.10.2018, p. 380-385.

Research output: Contribution to journalArticle

Giordano, A, Corcione, N, Ferraro, P, Bedogni, F, Testa, L, Sardella, G, Mancone, M, Tomai, F, De Persio, G, Iadanza, A, Frati, G & Biondi-Zoccai, G 2018, 'Outcome of Patients Undergoing Transcatheter Aortic Valve Implantation after Prior Balloon Aortic Valvuloplasty', Journal of Invasive Cardiology, vol. 30, no. 10, pp. 380-385.
Giordano, Arturo ; Corcione, Nicola ; Ferraro, Paolo ; Bedogni, Francesco ; Testa, Luca ; Sardella, Gennaro ; Mancone, Massimo ; Tomai, Fabrizio ; De Persio, Giovanni ; Iadanza, Alessandro ; Frati, Giacomo ; Biondi-Zoccai, Giuseppe. / Outcome of Patients Undergoing Transcatheter Aortic Valve Implantation after Prior Balloon Aortic Valvuloplasty. In: Journal of Invasive Cardiology. 2018 ; Vol. 30, No. 10. pp. 380-385.
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abstract = "OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is an effective treatment for severe aortic stenosis. Yet, balloon aortic valvuloplasty (BAV) is still occasionally offered to apparently inoperable patients as bridge or destination therapy, with some eventually receiving TAVI. We aimed to determine whether prior BAV would unfavorably impact TAVI. METHODS: The RISPEVA dataset was analyzed to compare the outcomes of non-BAV subjects undergoing TAVI vs those with prior BAV. Outcomes of interest were procedural results, hospital stay, and in-hospital outcomes, including major adverse events. Unadjusted and propensity-matched analyses were performed. RESULTS: A total of 1683 patients were included (1541 [91.6{\%}] non-BAV and 142 [8.4{\%}] prior BAV). Device success, procedural success, major adverse events and their individual components were all similar in the two groups, in both unadjusted and propensity-matched analyses. However, non-BAV patients had significantly shorter intensive/coronary care unit stay (8.1 ± 23.0 days vs 13.4 ± 35.2 days; P≤.03) and total hospital stay (12.4 ± 22.1 days vs 17.2 ± 32.7 days; P≤.02). Similar findings were obtained even in the propensity-matched groups (6.3 ± 11.9 days vs 13.6 ± 35.5 days [P≤.05] and 10.5 ± 13.8 days vs 17.4 ± 33.1 days [P≤.03], respectively). No significant interaction was found between device type and prior BAV status. CONCLUSION: BAV continues to offer a palliative solution to patients with unclear or poor prognosis and deemed at too high risk for emergent TAVI or surgery. Subjects undergoing BAV and surviving the post-BAV period can undergo TAVI without a significantly increased risk of in-hospital adverse events in comparison with non-BAV patients.",
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T1 - Outcome of Patients Undergoing Transcatheter Aortic Valve Implantation after Prior Balloon Aortic Valvuloplasty

AU - Giordano, Arturo

AU - Corcione, Nicola

AU - Ferraro, Paolo

AU - Bedogni, Francesco

AU - Testa, Luca

AU - Sardella, Gennaro

AU - Mancone, Massimo

AU - Tomai, Fabrizio

AU - De Persio, Giovanni

AU - Iadanza, Alessandro

AU - Frati, Giacomo

AU - Biondi-Zoccai, Giuseppe

PY - 2018/10/1

Y1 - 2018/10/1

N2 - OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is an effective treatment for severe aortic stenosis. Yet, balloon aortic valvuloplasty (BAV) is still occasionally offered to apparently inoperable patients as bridge or destination therapy, with some eventually receiving TAVI. We aimed to determine whether prior BAV would unfavorably impact TAVI. METHODS: The RISPEVA dataset was analyzed to compare the outcomes of non-BAV subjects undergoing TAVI vs those with prior BAV. Outcomes of interest were procedural results, hospital stay, and in-hospital outcomes, including major adverse events. Unadjusted and propensity-matched analyses were performed. RESULTS: A total of 1683 patients were included (1541 [91.6%] non-BAV and 142 [8.4%] prior BAV). Device success, procedural success, major adverse events and their individual components were all similar in the two groups, in both unadjusted and propensity-matched analyses. However, non-BAV patients had significantly shorter intensive/coronary care unit stay (8.1 ± 23.0 days vs 13.4 ± 35.2 days; P≤.03) and total hospital stay (12.4 ± 22.1 days vs 17.2 ± 32.7 days; P≤.02). Similar findings were obtained even in the propensity-matched groups (6.3 ± 11.9 days vs 13.6 ± 35.5 days [P≤.05] and 10.5 ± 13.8 days vs 17.4 ± 33.1 days [P≤.03], respectively). No significant interaction was found between device type and prior BAV status. CONCLUSION: BAV continues to offer a palliative solution to patients with unclear or poor prognosis and deemed at too high risk for emergent TAVI or surgery. Subjects undergoing BAV and surviving the post-BAV period can undergo TAVI without a significantly increased risk of in-hospital adverse events in comparison with non-BAV patients.

AB - OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is an effective treatment for severe aortic stenosis. Yet, balloon aortic valvuloplasty (BAV) is still occasionally offered to apparently inoperable patients as bridge or destination therapy, with some eventually receiving TAVI. We aimed to determine whether prior BAV would unfavorably impact TAVI. METHODS: The RISPEVA dataset was analyzed to compare the outcomes of non-BAV subjects undergoing TAVI vs those with prior BAV. Outcomes of interest were procedural results, hospital stay, and in-hospital outcomes, including major adverse events. Unadjusted and propensity-matched analyses were performed. RESULTS: A total of 1683 patients were included (1541 [91.6%] non-BAV and 142 [8.4%] prior BAV). Device success, procedural success, major adverse events and their individual components were all similar in the two groups, in both unadjusted and propensity-matched analyses. However, non-BAV patients had significantly shorter intensive/coronary care unit stay (8.1 ± 23.0 days vs 13.4 ± 35.2 days; P≤.03) and total hospital stay (12.4 ± 22.1 days vs 17.2 ± 32.7 days; P≤.02). Similar findings were obtained even in the propensity-matched groups (6.3 ± 11.9 days vs 13.6 ± 35.5 days [P≤.05] and 10.5 ± 13.8 days vs 17.4 ± 33.1 days [P≤.03], respectively). No significant interaction was found between device type and prior BAV status. CONCLUSION: BAV continues to offer a palliative solution to patients with unclear or poor prognosis and deemed at too high risk for emergent TAVI or surgery. Subjects undergoing BAV and surviving the post-BAV period can undergo TAVI without a significantly increased risk of in-hospital adverse events in comparison with non-BAV patients.

KW - Balloon aortic valvuloplasty

KW - Transcatheter aortic valve implantation

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