Effect of Balloon Aortic Valvuloplasty on Mortality in Patients With Severe Aortic Stenosis Prior to Conservative Treatment and Surgical or Transcatheter Aortic Valve Replacement

Outcomes following an initial strategy of balloon aortic valvuloplasty (BAV) prior to medical therapy or intervention with surgical or transcatheter aortic valve replacement (SAVR or TAVR) are unclear in the modern transcatheter intervention era. A retrospective, observational cohort study of the ec...

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Bibliographic Details
Published in:Heart, lung & circulation lung & circulation, 2020-05, Vol.29 (5), p.719-728
Main Authors: Jones, Dylan R., Chew, Derek P., Horsfall, Matthew J., Chuang, Anthony M., Sinhal, Ajay R., Joseph, Majo X., Baker, Robert A., Bennetts, Jayme S., Selvanayagam, Joseph B, Lehman, Sam J.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aortic stenosis (AS)
Aortic Valve - diagnostic imaging
Aortic Valve - surgery
Aortic Valve Stenosis - diagnosis
Aortic Valve Stenosis - mortality
Aortic Valve Stenosis - therapy
Australia - epidemiology
Balloon aortic valvuloplasty (BAV)
Balloon Valvuloplasty
Conservative Treatment - methods
Echocardiography - methods
Female
Follow-Up Studies
Humans
Male
Prognosis
Retrospective Studies
Risk Factors
Severity of Illness Index
Surgical aortic valve replacement (SAVR)
Survival Rate - trends
Time Factors
Transcatheter aortic valve replacement (TAVR)
Transcatheter Aortic Valve Replacement - methods
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Summary:Outcomes following an initial strategy of balloon aortic valvuloplasty (BAV) prior to medical therapy or intervention with surgical or transcatheter aortic valve replacement (SAVR or TAVR) are unclear in the modern transcatheter intervention era. A retrospective, observational cohort study of the echocardiography, cardiothoracic surgery and TAVR databases between 1 January 2006 and 31 December 2016 was performed to compare outcomes between all patients with severe aortic stenosis (AS) treated with or without BAV prior to medical or invasive therapy. 3,142 patients were available for analysis. 223 BAV treated patients had lower mortality relative to medically treated patients, particularly early (20.1% v. 7.6% at 6 months, 58.1% v. 52.5% at 5 years). Over 5 years, the adjusted hazard ratio (HR) was 0.62 (95% CI 0.48–0.80, p 
ISSN:1443-9506
1444-2892
DOI:10.1016/j.hlc.2019.06.717