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

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.

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.

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.

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).

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