Related Experiment Video
Updated: Sep 29, 2025
The Intra-Aortic Balloon Pump
Published on: February 5, 2021
Balloon aortic valvuloplasty review: the revenge during COVID-19 outbreak?
Bernardo Cortese1,2, Erick Sanchez-Jimenez3, Alfonso Ielasi4
1Department of Interventional Cardiology, San Carlo Polyspecialistic Clinic, Paderno Dugnano, Milan, Italy - bcortese@gmail.com.
Insights
Balloon aortic valvuloplasty offers a safe and effective option for patients with aortic stenosis awaiting definitive treatment. This procedure demonstrated high success rates, even during the COVID-19 pandemic, providing a vital bridge to valve replacement.
Area of Science:
- Cardiology
- Interventional Cardiology
- Valvular Heart Disease
Background:
- Aortic stenosis (AS) is a common age-related cardiac valvular disease with declining prognosis after symptom onset.
- Severe AS often requires intervention, but not all patients are candidates for surgical or transcatheter aortic valve replacement (TAVR).
- Balloon aortic valvuloplasty (BAV) serves as a bridge therapy or palliative option for inoperable AS patients.
Purpose of the Study:
- To review current indications and contraindications for BAV.
- To detail the procedural technique and common complications of BAV.
- To assess the safety and feasibility of BAV in patients awaiting TAVR during the COVID-19 pandemic.
Main Methods:
- Review of existing literature on BAV indications, contraindications, and techniques.
- Retrospective analysis of 33 consecutive patients undergoing BAV while on a TAVR waiting list.
- Data collection from 3 Italian centers during the COVID-19 pandemic waves.
Main Results:
- Procedural success was achieved in 31 out of 33 patients (94%).
- Fifteen patients proceeded to TAVR within 5±2 months post-BAV.
- At 6-month follow-up, only 2 patients died due to end-stage heart failure.
Conclusions:
- BAV is a safe and feasible procedure for selected aortic stenosis patients.
- It effectively serves as a bridge to TAVR, particularly in challenging circumstances like the COVID-19 pandemic.
- BAV can be successfully implemented in high-volume centers with appropriate patient selection.
Abstract:
Aortic stenosis is a highly prevalent cardiac valvular disease in adult population and increases with age. After symptoms onset in severe aortic stenosis, the prognosis begins to decline; however, new studies demonstrate an increased risk of death in patients with moderate disease. Although majority of patients with severe aortic stenosis are treated electively with surgical or transcatheter aortic valve replacement, not all patients are candidates for the interventions. Balloon aortic valvuloplasty can be used successfully as a bridge to definitive treatment or as palliative therapy in patients who are not candidates for either procedure. In this paper, we discuss and justify the current indications and contraindications for balloon aortic valvuloplasty. Additionally, the step-by-step procedure technique and most frequent complications are described. Moreover, we presented the safety and feasibility of balloon aortic valvuloplasty in 33 consecutive patients on a waiting list for transcatheter aortic valve replacement at 3 expert Italian centers during the first and second waves of COVID-19, when clinical priorities focused on hospitalized patients with pneumonia. The procedural success in this cohort of patients was achieved in 31 patients (94%). Out of the 33 patients enrolled, 15 underwent TAVR within 5±2 months from the valvuloplasty, and at 6-month follow-up a total of 2 patients died for end-stage heart failure.
