• Interv Cardiol · Sep 2017

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

    • Matteo Pagnesi, Luca Baldetti, Paolo Del Sole, Antonio Mangieri, Marco B Ancona, Damiano Regazzoli, Nicola Buzzatti, Francesco Giannini, Antonio Colombo, and Azeem Latib.
    • Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.
    • Interv Cardiol. 2017 Sep 1; 12 (2): 116-125.

    AbstractPredilatation 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.

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