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After its first description from Cribier et al in 1986, balloon aortic valvuloplasty (BAV) became in the 1990s a common procedure worldwide for high-risk patients with severe aortic stenosis offering a relevant immediate reduction of the transvalvular gradients.1 However, BAV exposes to a small risk of postprocedural severe aortic regurgitation while gradients return to significant levels in a high percentage of patients within a few months.2 In a recent study, no difference was observed after 1 year between conservative treatment and BAV.3 Thus, BAV indication is limited by the poor mid-term and long-term results due to the high rate of restenosis.
Regardless of these findings and the recent improvements of transcatheter valve replacement, which are now established even in low-risk patients, BAV procedures increased over the last years.4 The reason is probably due to multiple factors. With the success of transcatheter aortic valve implantation (TAVI), primary care is more inclined to refer to tertiary centres high-risk and frail patients who were previously treated palliatively.5 In this setting, a TAVI procedure may be considered futile and operators could opt …
Contributors DB drafted the manuscript. PP revised the manuscript and interpreted the results of the main paper.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Commissioned; externally peer reviewed.