Abstract
The introduction of transcatheter aortic valve replacement (TAVR) led to renewed interest in balloon aortic valvuloplasty (BAV). We sought to assess contemporary trends in BAV utilization and their outcomes. The Nationwide Inpatient Sample was used to identify patients who underwent BAV between 2004 and 2013. In-hospital morbidity and mortality, and predictors of death after BAV were assessed. Outcomes of propensity-matched groups of patients undergoing elective BAV or TAVR were evaluated. BAV utilization increased from 707 cases in 2004 to 3715 cases in 2013 (national estimates). Procedural and in-hospital mortality were 1.4% and 8.5%, respectively. Vascular complications occurred in 7.0% of cases, blood transfusion in 17.5%, clinical stroke in 1.8%, and pacemaker implantation in 3.0%. The strongest predictors of in-hospital death were cardiogenic shock (odds ratio, 6.01; 95% confidence interval, 4.19-8.61;P<0.001), need for left ventricular assist device (odds ratio, 3.48; 95% confidence interval, 2.25-5.36;P<0.001), coagulopathy (odds ratio, 2.19; 95% confidence interval, 1.51-3.18;P<0.001), and low institutional volume of BAV (odds ratio, 1.58; 95% confidence interval, 1.06-2.37;P=0.03). In propensity-matched patients under...Continue Reading
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