[Decompensated valve failure: the revival of balloon valvuloplasty - percutaneous valve intervention]

Calcified aortic stenosis is the dominating valve disease. Patients affected are most commonly elderly people, who often show associated comorbidities like reduced left ventricular function, impaired renal function, and pulmonary hypertension. The risk of open heart surgery is elevated. Balloon aortic valvuloplasty enables a reduction of symptoms, an increase in physical performance, and, therefore, an improved quality of life. Recent data also demonstrated an improved survival of patients after valvuloplasty. New techniques and improved equipment induced a "revival" of balloon aortic valvuloplasty, which has been introduced more than 20 years ago. In acute emergencies, however, mortality is high. Hemodynamic stabilization in the intensive care unit prior to valvuloplasty is recommended. If restenosis in aortic bioprosthesis has occurred, hemodynamic improvement is very limited. Surgical valve replacement or percutaneous transcatheter valve implantation as valve-in-valve must be considered in the short term.