Abstract P57: The Baseline Characteristics Predictive of a Poor Procedural Response to Balloon Aortic Valvuloplasty Among a Cohort of High–Surgical Risk Patients with Aortic Stenosis

Abstract

Background: Balloon aortic valvuloplasty (BAV) for high-surgical risk patients with severe aortic stenosis (AS) has been used as a palliative therapy, a bridge to surgical aortic valve replacement (AVR) or to transcatheter aortic valve implantation (TAVI). Poor procedural response, including poor improvements in the aortic valve area (AVA) and the mean aortic valve pressure gradient (AVPG) immediately following BAV have been demonstrated to predict mortality following BAV. Whether any baseline characteristics can predict a poor procedural response to BAV has not been assessed. Methods: We retrospectively reviewed the medical records of 74 consecutive, AS patients who underwent BAV. Patient's baseline demographics, comorbid medical conditions, medications, laboratory results and echocardiographic findings were correlated with changes in the AVA and the mean AVPG immediately post-BAV. Results: The mean age was 80 ± 4 years, the mean Society of Thoracic Surgeons Surgical Risk Score (STS) was 7.73 ± 6.26 and the mean logistic EuroSCORE was 23.8 ± 15.4. There was 1 periprocedural death, 16 (21.6%) patients were bridged to AVR or to TAVI and 58 (78.3%) of the patients received palliative or definitive therapy. The mean AVA increased from 0.72 ± 0.24 cm 2 to 1.12 ± 0.42 cm 2 and the mean AVPG decreased from 42.09 ± 16.54 mmHg to 24.41 ± 10.86 mmHg. Overall, no baseline characteristics were statistically significant predictors of poor AVA improvements following BAV (Table 1). Patient's age < 80 years old was the only significant, independent predictor of poor AVPG reduction post-BAV compared to patient's > 80 years of age (Table 1). Conclusion: Prior to BAV, age < 80 years of age was the only characteristic predictive of a poor procedural response. All other baseline characteristics including patient demographics, pre-existing medical conditions, active medications and laboratory values were poor predictors of the procedural response to BAV therapy.