Mortality after radial-only balloon aortic valvuloplasty: a long-term follow-up and a bridge-to-TAVI analysis
Article Category: Original Article
Published Online: Aug 01, 2023
Page range: 93 - 98
DOI: https://doi.org/10.2478/rjc-2023-0014
Keywords
© 2023 Alexandru Achim et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Background
The benefits of distal radial balloon aortic valvuloplasty were recently reported: same efficacy as the classical femoral approach, with no vascular complications. The long-term outcomes for these patients remain unknown.
Methods
We retrospectively analyzed the long-term mortality and the impact of TAVI in a cohort of 30 patients who underwent distal radial (DR) BAV.
Results
The mean age was 78.3 ± 7.14 years and the median follow-up was 22.8 months. The indication for BAV was stable aortic stenosis in 70% of patients, while 23% of patients had concomitant acute heart failure symptoms and 6.6% of patients were in cardiogenic shock. A total of 16 patients (53.3%) received TAVI during follow-up after their BAV procedure while the remainder only received BAV. All-cause mortality was 20%, with only 1 death (6.3%) in the “BAV + TAVI” group compared to 5 deaths (35.7%) in the “BAV only” group (p = 0.089). All of the TAVI procedures were performed within 7 months after BAV. Cumulative incidence of TAVI was 40.0% at 5 months and 50.0% at 10 months. Cumulative incidence of death was 6.7% at 5 months, 13.3% at 10 months, 16.7% at 15 months, and 20.0% at 25 months. The probability of being alive without TAVI decreased from 53.3% at 5 months to 30.0% at 25 months.
Conclusion
In the present study, we could show that half of the patients undergoing BAV eventually need TAVI, most of them within 5 months after BAV, and that BAV remains associated with high mortality after the procedure, with 35% of those undergoing isolated BAV dying during short-term follow-up.