Balloon Aortic Valvuloplasty: Patient Selection and Technical Considerations

Abstract

BAV has had resurgence in association with the dissemination of TAVR. The lack of clear mortality benefit from BAV does not translate to lack of efficacy as a palliative therapy. BAV remains a useful bridge to surgical AVR or TAVR, and for symptom relief in patients who are not candidates for either AVR approach. It is also useful as a diagnostic test for patients with low gradient-low output AS, and for those with mixed pulmonary and aortic valvular disease. BAV is used commonly for TAVR pre dilatation, and this is sometimes helpful for annulus size assessment. Careful attention to balloon diameter selection and the details of technique are important for optimizing outcomes.