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Predilatation Prior to Transcatheter Aortic Valve Implantation: Is it Still a Prerequisite?


ABSTRACT: Predilatation has been historically considered a mandatory step before transcatheter aortic valve implantation (TAVI) since it facilitates valve crossing and prosthesis delivery, ensures optimal valve expansion and improves hemodynamic stability during valve deployment. However, as a result of procedural evolution over time, direct TAVI (without pre-implantation balloon aortic valvuloplasty) has emerged as an interesting option to simplify the procedure and to avoid potential valvuloplasty-related complications. Several real-world retrospective studies and one small randomised study have shown that direct TAVI (with both self-expanding and balloon-expandable prostheses) is feasible, safe and associated with outcomes similar to standard TAVI with pre-implantation balloon aortic valvuloplasty. In the absence of high-quality, robust evidence, the current review aims to discuss the advantages and disadvantages of omitting predilatation prior to TAVI.

SUBMITTER: Pagnesi M 

PROVIDER: S-EPMC5808664 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Predilatation Prior to Transcatheter Aortic Valve Implantation: Is it Still a Prerequisite?

Pagnesi Matteo M   Baldetti Luca L   Del Sole Paolo P   Mangieri Antonio A   Ancona Marco B MB   Regazzoli Damiano D   Buzzatti Nicola N   Giannini Francesco F   Colombo Antonio A   Latib Azeem A  

Interventional cardiology (London, England) 20170901 2


Predilatation has been historically considered a mandatory step before transcatheter aortic valve implantation (TAVI) since it facilitates valve crossing and prosthesis delivery, ensures optimal valve expansion and improves hemodynamic stability during valve deployment. However, as a result of procedural evolution over time, direct TAVI (without pre-implantation balloon aortic valvuloplasty) has emerged as an interesting option to simplify the procedure and to avoid potential valvuloplasty-relat  ...[more]

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