Clinical and hemodynamic results after direct transcatheter aortic valve replacement versus pre‐implantation balloon aortic valvuloplasty: A case‐matched analysis

Objectives To evaluate the safety and midterm hemodynamic results of direct transcatheter aortic valve replacement (TAVR) without pre‐implantation balloon aortic valvuloplasty (BAV). Background BAV was considered a mandatory previous step in TAVR procedures. Methods A total of 339 consecutive patients who underwent transfemoral TAVR were prospectively selected. A 1:1 matching was conducted, pairing age, prosthesis type (self‐expandable or balloon expandable) and size, and valve calcification grade (48% with moderate to severe valve calcification). Finally, 102 pairs (102 patients with previous BAV and 102 without BAV) were obtained. Results Direct TAVR was feasible in all patients without any crossover to BAV group. Device success was achieved in 91.2% and 90.2% of cases in direct TAVR and pre‐BAV groups (P = 0.810), respectively, without any differences in balloon postdilation rate and residual aortic regurgitation. The amount of contrast agent, acute kidney injury and myocardial injury was significantly lower in the direct implantation group (P