We used a nationwide cohort to (1) compare characteristics and outcomes of patients
who underwent balloon aortic valvuloplasty (BAV) in pre–transcatheter aortic valve
transplantation (TAVI) and TAVI eras, (2) examine trends in utilization and outcomes
of BAV from 2005 to 2017, (3) assess the association of BAV procedural volume with
hospital-based TAVI volume, and (4) understand trends and outcomes of BAV in TAVI
and non-TAVI centers in the TAVI era. Pre-TAVI era included hospitalizations from
2005 to 2011, and TAVI era included hospitalizations from 2012 to 2017. In the TAVI
era, hospitals were classified into quartiles based on the number of TAVI procedures
performed. Trends in volume of BAV procedures from 2012 to 2017 were assessed in non-TAVI
and TAVI centers (based on TAVI volume). Between 2005 and 2017, a total of 6,962 hospitalizations
for BAV were identified. There were no significant differences in in-hospital mortality
or stroke between pre-TAVI and TAVI eras (mortality: pre-TAVI, 8.5% vs TAVI era, 9.3%,
p = 0.354; stroke: pre-TAVI, 1.9% vs TAVI era, 1.3%, p = 0.083). However, acute kidney
injury was more prevalent in the TAVI era and blood transfusion in the pre-TAVI era.
Importantly, patients who underwent BAV in the TAVI era were more likely to have a
greater number of co-morbidities and to undergo nonelective procedures. From 2005
to 2017, there was 10-fold increase in utilization of BAV. In the TAVI era, the maximum
increase in number of BAV procedures was seen in hospitals with highest TAVI volume.
In conclusion, although BAV procedural volume increased approximately 10-fold between
2005 and 2017, with concomitant expansion of TAVI, rates of mortality and stroke have
remained stable. Despite this, the rate of BAV utilization continues to increase,
thereby indicating a significant opportunity to improve outcomes in this patient population.
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Article Info
Publication History
Published online: July 16, 2022
Received in revised form:
May 8,
2022
Received:
February 9,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
