Portal de Periódicos da CAPES

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

2017; Volume: 12; Issue: 02 Linguagem: Inglês

10.15420/icr.2017

1756-1477

Matteo Pagnesi, Luca Baldetti, Paolo Del Sole, Antonio Mangieri, Marco Ancona, Damiano Regazzoli, Nicola Buzzatti, Francesco Giannini, Antonio Colombo, Azeem Latib,

Aortic Disease and Treatment Approaches

Predilatation 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.