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Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Interv+Cardiol 2017 ; 12 (2): 116-25 Nephropedia Template TP
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Predilatation Prior to Transcatheter Aortic Valve Implantation: Is it Still a Prerequisite? #MMPMID29588739
Pagnesi M; Baldetti L; Del Sole P; Mangieri A; Ancona MB; Regazzoli D; Buzzatti N; Giannini F; Colombo A; Latib A
Interv Cardiol 2017[Sep]; 12 (2): 116-25 PMID29588739show ga
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.