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Predictive factors, efficacy, and safety of balloon post-dilation after transcatheter aortic valve implantation with a balloon-expandable valve

Nombela-Franco, Luis, Rodés-Cabau, Josep, DeLarochellière, Robert, Larose, Eric, Doyle, Daniel, Villeneuve, Jacques, Bergeron, Sebastien, Bernier, Mathieu, Amat-Santos, Ignacio J., Mok, Michael, Urena, Marina, Rheault, Michel, Dumesnil, Jean, Côté, Melanie, Pibarot, Philippe and Dumont, Eric 2012, Predictive factors, efficacy, and safety of balloon post-dilation after transcatheter aortic valve implantation with a balloon-expandable valve, JACC: Cardiovascular interventions, vol. 5, no. 5, pp. 499-512, doi: 10.1016/j.jcin.2012.02.010.

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Title Predictive factors, efficacy, and safety of balloon post-dilation after transcatheter aortic valve implantation with a balloon-expandable valve
Author(s) Nombela-Franco, Luis
Rodés-Cabau, Josep
DeLarochellière, Robert
Larose, Eric
Doyle, Daniel
Villeneuve, Jacques
Bergeron, Sebastien
Bernier, Mathieu
Amat-Santos, Ignacio J.
Mok, Michael
Urena, Marina
Rheault, Michel
Dumesnil, Jean
Côté, Melanie
Pibarot, Philippe
Dumont, Eric
Journal name JACC: Cardiovascular interventions
Volume number 5
Issue number 5
Start page 499
End page 512
Total pages 14
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2012-05
ISSN 1936-8798
1876-7605
Keyword(s) aged
aged, 80 and over
aortic valve insufficiency
aortic valve stenosis
calcinosis
cardiac catheterization
catheterization
cerebrovascular disorders
chi-square distribution
echocardiography, doppler, color
Echocardiography, Transesophageal
Female
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Predictive Value of Tests
Prospective Studies
Prosthesis Design
Quebec
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
balloon post-dilation
stroke
transapical
transcatheter aortic valve implantation
transcatheter aortic valve replacement
transfemoral
Summary OBJECTIVES: This study sought to evaluate the predictive factors, effects, and safety of balloon post-dilation (BPD) for the treatment of significant paravalvular aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI). BACKGROUND: Very few data exist on BPD after TAVI with a balloon-expandable valve. METHODS: A total of 211 patients who underwent TAVI with a balloon-expandable valve were included. BPD was performed after TAVI if paravalvular AR ≥ 2 was identified by transesophageal echocardiography. Clinical events and echocardiographic data were prospectively recorded, and median follow-up was 12 (6 to 24) months. RESULTS: BPD was performed in 59 patients (28%), leading to a reduction in at least 1 degree of AR in 71% of patients, with residual AR <2 in 54% of the patients. The predictors of the need for BPD were the degree of valve calcification and transfemoral approach, with valve calcification volume >2,200 and >3,800 mm(3) best determining the need for and a poor response to BPD, respectively. Patients who underwent BPD had a higher incidence of cerebrovascular events at 30 days (11.9% vs. 2.0%, p = 0.006), with most (83%) events within the 24 h after the procedure occurring in patients who had BPD. No significant changes in valve area or AR degree were observed at follow-up in BPD and no-BPD groups. CONCLUSIONS: BPD was needed in about one-fourth of the patients undergoing TAVI with a balloon-expandable valve and was successful in about one-half of them. A higher degree of valve calcification and transfemoral approach predicted the need for BPD. BPD was not associated with any deleterious effect on valve function at mid-term follow-up, but a higher rate of cerebrovascular events was observed in patients who had BPD.
Language eng
DOI 10.1016/j.jcin.2012.02.010
Field of Research 110201 Cardiology (incl Cardiovascular Diseases)
1102 Cardiovascular Medicine And Haematology
Socio Economic Objective 920103 Cardiovascular System and Diseases
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2012, American College of Cardiology Foundation
Persistent URL http://hdl.handle.net/10536/DRO/DU:30073400

Document type: Journal Article
Collection: School of Medicine
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