• Marzena Daniec, Danuta Sorysz, Artur Dziewierz, Paweł Kleczyński, Łukasz Rzeszutko, Agata Krawczyk-Ożóg, and Dariusz Dudek.
• Second Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
• J Interv Cardiol. 2018 Feb 1; 31 (1): 60-67.

BackgroundSevere aortic stenosis (AS) often coexists with significant coronary artery disease.ObjectiveTo evaluate procedural complications and long-term outcomes of patients with severe AS undergoing balloon aortic valvuloplasty (BAV) and percutaneous coronary intervention (PCI).MethodsA total of 97 patients with severe AS underwent 104 BAVs as palliative procedure, bridge to definitive treatment, or before urgent non-cardiac surgery. Patients were followed-up for at least 12 months.ResultsOf the 97 patients, 34 (35.0%) underwent standalone BAV, 45 (46.4%) underwent BAV with coronary angiography, and 18 (18.6%) BAV with PCI. There were no differences in baseline characteristics and indications for BAV among the groups (P > 0.05). No higher risk of complications after BAV performed with concomitant coronary angiography/PCI was observed. Transcatheter aortic valve implantation was performed after BAV in 13 (13.4%) patients and surgical aortic valve replacement in three (3.1%) patients. In spite of no difference in in-hospital mortality (5.6% vs. 8.9%; P = 0.76), patients with BAV and concomitant PCI had lower long-term mortality than patients with BAV and concomitant coronary angiography (28.5% vs. 51.0%; P = 0.03). In multivariable Cox analysis adjusted for age, sex, and body mass index, the Society of Thoracic Surgeons Predicted Risk of Mortality score was identified as the only independent predictor of long-term mortality for all patients (HR: 1.09, 95%CI: 1.04-1.15, P = 0.0006).ConclusionsConcomitant PCI or coronary angiography performed with BAV may not increase the risk of major and vascular complications. Patients with BAV and concomitant PCI may have better survival than patients with BAV and concomitant coronary angiography.© 2017, Wiley Periodicals, Inc.

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