Chapter 55
Aortic Valvuloplasty and Large-Bore Percutaneous Arterial Access
Matthew I. Tomey,
Anton Camaj,
Annapoorna S. Kini,
Samin K. Sharma,
Matthew I. Tomey
Search for more papers by this authorAnton Camaj
Search for more papers by this authorAnnapoorna S. Kini
Search for more papers by this authorSamin K. Sharma
Search for more papers by this authorMatthew I. Tomey,
Anton Camaj,
Annapoorna S. Kini,
Samin K. Sharma,
Matthew I. Tomey
Search for more papers by this authorAnton Camaj
Search for more papers by this authorAnnapoorna S. Kini
Search for more papers by this authorSamin K. Sharma
Search for more papers by this authorBook Editor(s):George D. Dangas MD, MACC, MSCAI, FAHA, FESC,
Carlo Di Mario MD, PhD, FRCP, FACC, FSCAI, FESC,
Holger Thiele MD,
Peter Barlis MBBS, MPH, PHD, FACC, FESC, FRACP,
Tayo Addo MD, Bimmer Claessen MD, Christian Hengstenberg MD, Nicholas Kipshidze MD,
George D. Dangas MD, MACC, MSCAI, FAHA, FESC
Professor of Medicine (Cardiology) & Surgery (Vascular) Professor of Cardiology Adjunct Professor of Internal Medicine
Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, NY, USA
National Kapodistrian University of Athens, Greece
Medical University of Vienna, Austria
Search for more papers by this authorCarlo Di Mario MD, PhD, FRCP, FACC, FSCAI, FESC
Professor of Cardiology Director of the Structural Interventional Cardiology Division Honorary Consultant
University of Florence
University Hospital Careggi, Florence, Italy
Cardiologist Royal Brompton Hospital, London, UK
Search for more papers by this authorHolger Thiele MD
Professor of Cardiology at University of Leipzig
Heart Center Leipzig at University of Leipzig, Leipzig, Germany
Search for more papers by this authorPeter Barlis MBBS, MPH, PHD, FACC, FESC, FRACP
Professor of Cardiology Interventional Cardiologist
University of Melbourne, Melbourne, Victoria, Australia
St Vincent's & Northern Hospitals Victoria, Australia
Search for more papers by this authorFirst published: 06 May 2022
Summary
Percutaneous balloon aortic valvuloplasty (BAV) is a minimally invasive structural intervention for management of symptomatic severe valvular AS which emerged in the 1980s, first used in children with congenital AS and subsequently in adults with bicuspid aortic valve disease, rheumatic heart disease, and calcific AS. In the absence of aortic valve replacement (AVR), symptomatic severe AS portends a high risk of mortality that has remained largely unchanged despite advances in medical therapy. Before the recent advent of transcatheter AVR (TAVR), only half of older adults with severe AS would ever visit a cardiothoracic surgeon, and fewer still would ultimately undergo AVR. This chapter provides a comprehensive reassessment of BAV and large-bore arterial access for adult patients with calcific AS in the era of TAVR. It discusses the optimal approach to large-bore arterial access and retrograde percutaneous transfemoral BAV, acknowledging that there exist inter-institutional and inter-operator differences in technique, preference, and style.
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