Balloon aortic valvuloplasty through the novel transradial technique

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Vascular Access Techniques

Background:

• Traditional femoral access for balloon aortic valvuloplasty (BAV) is associated with increased risks of bleeding and vascular complications.
• Exploring alternative access routes is crucial for improving patient safety and procedural outcomes in BAV.

Purpose of the Study:

• To evaluate the safety and efficacy of transradial aortic valve valvuloplasty (TRBAV).
• To assess procedural success rates and complication profiles associated with the transradial approach for BAV.

Main Methods:

• Retrospective, single-center study of patients undergoing TRBAV between October 2019 and July 2020.
• BAV performed using 18-25 mm balloons via 8-10 French radial sheaths.
• Success defined as ≥50% reduction in peak-to-peak aortic gradient; safety assessed via procedural complications and radial artery occlusion (RAO).

Main Results:

• Ninety-one percent (91%) of the 24 patients achieved successful BAV, with a significant reduction in mean aortic valve gradient (50±24 mmHg pre- to 18.7±13 mmHg post-procedure).
• The procedure utilized predominantly 8F and 9F sheaths for 20 mm and 23 mm balloons.
• Low complication rates observed: no major procedural complications, no access-site bleeding, and asymptomatic RAO in 8% of patients (2/24).

Conclusions:

• Transradial aortic valve valvuloplasty (TRBAV) is a safe, feasible, and effective alternative to femoral access for selected patients.
• The technique demonstrates reproducibility with a low rate of conversion and radial artery occlusion.
• Larger studies are warranted to further confirm the utility of TRBAV.