Emergency (“Bailout”) balloon aortic valvuloplasty following diagnostic cardiac catheterisation in a patient with severe valvular aortic stenosis and severe coronary artery disease.

Abstract

Balloon aortic valvuloplasty is usually a palliative procedure, performed on an elective basis, undertaken in elderly or frail patients deemed unsuitable for surgical aortic valve replacement. It has previously been shown to improve symptoms, though not prolong survival. We report the case of a patient with severe aortic stenosis (diagnosed on echocardiography) who was also found to have severe coronary artery disease at the time of diagnostic cardiac catheterisation. He experienced profound acute haemodynamic deterioration immediately following the procedure. This did not improve after urgent percutaneous coronary revascularisation and intra-aortic balloon pump insertion. He did however improve after successful emergency balloon aortic valvuloplasty. Our literature search leads us to believe this is the first such case of successful emergency aortic valvuloplasty following routine cardiac catheterisation in a patient with both severe aortic stenosis and severe coronary artery disease.