eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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4/2021
vol. 17
 
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abstract:
Original paper

Safety and feasibility of transradial aortic valve valvuloplasty (TRAV study)

Levente Molnár
1
,
Roland Papp
1
,
Tímea Szigethi
1
,
István F. Édes
1
,
Dávid Becker
1
,
Olivier F. Bertrand
2
,
Béla Merkely
1
,
Zoltán Ruzsa
3

  1. Heart and Vascular Center, Semmelweis University, Budapest, Hungary
  2. Cardiology Department, University Laval, Quebec, Canada
  3. Invasive Cardiology Division, Internal Medicine Department, University of Szeged, Szeged, Hungary
Adv Interv Cardiol 2021; 17, 4 (66): 381–388
DOI: https://doi.org/10.5114/aic.2021.111341
Online publish date: 2021/12/30
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Introduction
The importance of balloon aortic valvuloplasty (BAV) in the transcatheter aortic valve implantation (TAVI) era emerged in the past decades, but the access site related complication rate remained significant.

Aim
To establish the safety and technical success of transradial balloon aortic valvuloplasty (trBAV). The secondary objective was to determine the effectiveness and appropriate role of trBAV.

Material and methods
Between 2017 and 2019, 36 consecutive patients with symptomatic aortic stenosis (AoS) were treated with trBAV in this prospective, single-center study. During the procedure, the efficacy and the aortic valve insufficiency were controlled by hemodynamic measurements and later by echocardiography. The primary end-points were technical success and major adverse events (MAE). Secondary end-points were the access site complication rate, hemodynamic and clinical result of the intervention, procedure-related factors, crossover rate to the femoral access site and hospitalization duration.

Results
Clinical and technical success was achieved in all cases. Invasively measured peak-to-peak gradient decreased from 76.8 ±27.2 to 54.7 ±21.1 mm Hg (p = 0.001), and the aortic-valve area increased from 0.69 ±0.2 to 0.91 ±0.3 cm2 (p = 0.001). No major adverse cardiac or cerebrovascular events or vascular complications (according to VARC 2 criteria) occurred during the procedures. The perioperative death rate was 2.7% (n = 1).

Conclusions
According to our study, radial artery access is a safe and effective option for balloon aortic valvuloplasty in patients with severe aortic valve stenosis.

keywords:

vascular complications, aortic valve valvuloplasty, transradial approach
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