Balloon aortic valvuloplasty in elderly patients : a review & update review

Calcific aortic stenosis is the most common valvular disease in the western world, with the prevalence increasing with age. Medical management of critical aortic stenosis is associated with high mortality and cost. While surgical valve replacement is ideal, high early morbidity and mortality limit its usefulness among patients with comorbid illness or advanced age. Balloon aortic valvuloplasty can be an important option that can be used as a bridge to definitive replacement or as palliative therapy. Fewer complications and easier recovery may make balloon aortic valvuloplasty a particularly attractive option for very elderly patients. Reducing the balloon profile reduces complications. A case series using a low-profile balloon with rapid inflation to achieve more effective force on calcified valves resulted in good shortand long-term outcomes. Future studies should seek longer-term data and investigate pathological changes following valvuloplasty.