Zhong Jeffrey, Kamp Nicholas, Bansal Agam, Kumar Ani, Puri Rishi, Krishnaswamy Amar, Kapadia Samir, Reed Grant W
Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
J Soc Cardiovasc Angiogr Interv. 2023 Jul 27;2(4):101002. doi: 10.1016/j.jscai.2023.101002. eCollection 2023 Jul-Aug.
Balloon aortic valvuloplasty (BAV) improves the hemodynamics and symptoms of patients with severe aortic stenosis in the short term with low rates of complications, but has not been shown to be an effective destination therapy. Our pooled analysis of >14,300 patients from studies published between January 1, 1991, and April 31, 2022, reported intraprocedural mortality and in-hospital mortality rates as 1.94% (95% CI, 1.39%-2.59%) and 6.02% (95% CI, 4.83%-7.32%), respectively. Hence, BAV is primarily indicated as a bridge to aortic valve replacement/decision with secondary uses as bridge to noncardiac surgery and palliative therapy. Recent advancements in alternative access sites, balloon catheters, and lithotripsy for BAV have opened opportunities for expanded use and further improvements in complication rates. As the utilization of BAV has continually increased since the advent of transcatheter aortic valve replacement, reexamining the role and outcomes of BAV in the era of transcatheter aortic valve replacement has become increasingly important. This review focuses on the outcomes, indications, advances, and technical considerations for BAV.
球囊主动脉瓣成形术（BAV）在短期内可改善重度主动脉瓣狭窄患者的血流动力学和症状，并发症发生率较低，但尚未被证明是一种有效的最终治疗方法。我们对1991年1月1日至2022年4月31日期间发表的研究中超过14300例患者进行的汇总分析报告，术中死亡率和住院死亡率分别为1.94%（95%CI，1.39%-2.59%）和6.02%（95%CI，4.83%-7.32%）。因此，BAV主要作为主动脉瓣置换/决策的桥梁，其次用作非心脏手术和姑息治疗的桥梁。BAV在替代入路部位、球囊导管和碎石术方面的最新进展为扩大其应用范围和进一步降低并发症发生率带来了机遇。自经导管主动脉瓣置换术问世以来，随着BAV的应用不断增加，重新审视BAV在经导管主动脉瓣置换术时代的作用和结局变得越来越重要。本综述重点关注BAV的结局、适应证、进展和技术要点。
