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Transcatheter Aortic Valve Implantation pp 339–349Cite as

Predilation in Transcatheter Aortic Valve Implantation

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Abstract

The need for predilation in transcatheter aortic valve implantation (TAVI) is a matter of ongoing debate. Performed under rapid overdrive pacing with the use of non-compliant or semi-compliant balloons, predilation aims at increasing aortic valve area to facilitate passage of the delivery catheter across the native aortic valve, to facilitate prosthesis positioning, and to allow adequate expansion of the transcatheter heart valve (THV). Potential complications of predilation are manifold and include hemodynamic deterioration, severe aortic regurgitation, cardiac perforation, aortic (annulus) rupture, coronary obstruction, stroke, and conduction disturbances. The clinical evidence for the routine use of predilation is limited mainly to retrospective studies and meta-analyses, most of which suggest safety and feasibility of “direct TAVI” in selected patients. Until the results of ongoing randomized trials are available, patient characteristics including aortic valve morphology and amount of calcification should lead the decision whether to use predilation in an individual TAVI patient.

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Authors and Affiliations

  1. Heart Center Bonn, University Hospital Bonn, Bonn, Germany

    Alexander Sedaghat, Eberhard Grube & Jan-Malte Sinning

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  1. Alexander Sedaghat
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Editors and Affiliations

  1. Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy

    Arturo Giordano

  2. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy

    Giuseppe Biondi-Zoccai  & Giacomo Frati  & 

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Sedaghat, A., Grube, E., Sinning, JM. (2019). Predilation in Transcatheter Aortic Valve Implantation. In: Giordano, A., Biondi-Zoccai, G., Frati, G. (eds) Transcatheter Aortic Valve Implantation. Springer, Cham. https://doi.org/10.1007/978-3-030-05912-5_28

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