Safety, efficacy and impact on frailty of mini-invasive radial balloon aortic valvuloplasty.

Abstract

OBJECTIVE:

The study was designed to: (1) confirm safety and feasibility of mini-invasive radial balloon aortic valvuloplasty (BAV); (2) assess its impact in terms of quality of life and frailty; and (3) evaluate whether changes in frailty after BAV are associated with death in patients undergoing transcatheter aortic valve implantation (TAVI).

METHODS:

330 patients undergoing BAV in 16 Italian centres were prospectively included. The primary endpoint was the occurrence of major and minor Valve Academic Research Consortium (VARC)-2 bleeding. Secondary endpoints were scales of quality of life, frailty, evaluated at baseline and 30 days, and their relationship with the occurrence of all-cause death.

RESULTS:

BAV was performed by radial access in 314 (95%) patients. No VARC-2 major and six (1.8%) VARC-2 minor bleedings occurred in the study population. Quality of life, as well as frailty status, significantly improved 30 days after BAV. At 1 year, patients undergoing TAVI with baseline essential frailty toolset (EFT) <3 or achieving an EFT <3 after BAV had a comparable occurrence of all-cause death (15% vs 19%, p=0.58). On the contrary, patients with EFT ≥3 at 30 days despite BAV showed the worst prognosis (all-cause death: 40% vs 15% and 19%, p=0.006 and p=0.05, respectively).

CONCLUSIONS:

Mini-invasive radial BAV is safe, feasible and associated with a low rate of vascular complications. Patients improving EFT 30 days after BAV showed a favourable outcome after TAVI.

TRIAL REGISTRATION NUMBER:

NCT03087552.

• Authors: Carlo Tumscitz, Annamaria Di Cesare, Marco Balducelli, Tommaso Piva, Andrea Santarelli, Francesco Saia, Fabio Tarantino, Gerlando Preti, Andrea Picchi, Cristina Rolfo, Tiziana Attisano, Giuseppe Colonna, Giuseppe De Iaco, Guido Parodi, Massimo Di Marco, Enrico Cerrato, Simona Pierini, Luca Fileti, Caterina Cavazza, Gianni Dall'Ara, Benedetta Govoni, Giacomo Mantovani, Matteo Serenelli, Carlo Penzo, Matteo Tebaldi, Gianluca Campo, Simone Biscaglia
• Journal: Heart (British Cardiac Society) (Heart) Vol. 107 Issue 11 Pg. 874-880 (06 2021) ISSN: 1468-201X [Electronic] England
• PMID: 33627400 (Publication Type: Journal Article, Multicenter Study, Observational Study)
• Copyright: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Topics

• Aged, 80 and over
• Aortic Valve Stenosis (therapy)
• Balloon Valvuloplasty
• Feasibility Studies
• Female
• Frailty
• Humans
• Male
• Mortality
• Prognosis
• Prospective Studies
• Quality of Life
• Radial Artery