Impact of balloon aortic valvuloplasty on transcatheter aortic valve implantation with self-expandable valve

Background Balloon aortic valvuloplasty (BAV) has been used prior to valve implantation of a self-expandable valve as part of the transcatheter aortic valve implantation (TAVI) procedure. We aimed to evaluate the impact of BAV prior to TAVI. Methods We retrospectively studied 203 consecutive patients who were treated either with (pre-BAV-TAVI group) or without BAV (D-TAVI group). Implantation depth (ID) was angiographically measured at non-coronary cusp (NCC) and left coronary cusp (LCC) at: the starting point (stage-1), before (stage-2), and after (stage-3) final bioprosthesis release. Paravalvular regurgitation (PVR) and 1-year clinical follow-up were recorded. Results Overall, from stage-1 to stage-3, prosthesis migrated toward the left ventricle, in both cusps and groups. At NCC a forward migration was observed from stage-1 to stage-2 in both groups (p < 0.001). In the pre-BAV-TAVI group only, at NCC, an upward migration decreased the ID from stage-2 to stage-3 (p = 0.022). PVR ≥grade 2, immediately after expansion was more frequently observed in pre-BAV-TAVI group (41% vs 22%, respectively; p = 0.024). However, PVR was similar at discharge. Clinical parameters were comparable between the two groups. Conclusions The use of BAV prior to TAVI may have an impact on device final position, but not on short- and long-term clinical outcome.