Balloon Valvoplasty of Severe Aortic Valve Stenosis Following Badly Planed Midline Thoracotomy
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Abstract
Aortic valve replacement (AVR) is the gold standard method for management of severe aortic stenosis (AS), with transcatheter balloon valvoplasty (BAV) increasingly used as palliative option for calcified valve in experienced hand. In the AVR era, BAV was not considered a long-term definitive treatment for severe calcific AS due to a high restenosis rate and short durability of gradient improvement. However, it continues to have an important role as a bridge-to-decision or bridge-to-intervention in cases where definitive therapy must be delayed due to clinical instability, imaging uncertainty or failed trial of surgical valve replacement. We report a case of heavily calcified AS in an adolescent female, in which the calcification involves the ascending aorta extending to the aortic arch with failure of surgical management trail and she finally managed by transcatheter balloon valvoplasty.
References
- Pascoal CAD, Faria HS, Francisco AdeJ, Peres CdeAP, Tavares LF, Masiero BB, et al. Mid-Term Outcomes of Transcatheter Aortic Valve Replacement vs. Surgical Aortic Valve Replacement in Low-to-Moderate Risk Patients with Severe Aortic Stenosis: A Systematic Review and Meta-Analysis. Braz. J. Cardiovasc. Surg. 2026, 41(1):e e20240250. Doi: https://doi.org/10.21470/1678-9741-2024-0250.
- Bjursten H, Koul S, Duvernoy O, Fagman E, Samano N, Nilsson J, et al. Calcium load in the aortic valve, aortic root, and left ventricular outflow tract and the risk for a periprocedural stroke. Structural Heart. 2022;6(4):100070. Doi: https://doi.org/10.1016/j.shj.2022.100070
- Cabrita A, Marques CA, Vasconcelos M, Rodrigues RA. Aortic dissection: an unexpected complication of transcatheter aortic valve implantation. Cureus. 2025;17(2):e78607. Doi: https://doi.org/10.7759/cureus.78607.
- Laohachewin D, Ruile P, Breitbart P, Minners J, Jander N, Soschynski M, et al. Quantification of aortic valve calcification in contrast-enhanced computed tomography. J Clin Med. 2024;13(8):2386. Doi: https://doi.org/10.3390/jcm13082386.
- Otto CM, Newby DE, Hillis GS. Calcific aortic stenosis: a review. JAMA. 2024;332(23):2014-26, Doi: https://doi.org/10.1001/jama.2024.16477.
- Praz F, Borger MA, Lanz J, Marin-Cuartas M, Abreu A, Adamo M, et al. 2025 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J. 2025;46(48):4635-736. Doi: https://doi.org/10.1093/eurheartj/ehaf194.
- Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease. J Am Coll Cardiol. 2021;77(4):e25-e197. doi: https://doi.org/10.1016/j.jacc.2020.11.018.
- Singh, G.K. Congenital Aortic Valve Stenosis. Children 2019,6(5):69. Doi: https://doi.org/10.3390/CHILDREN6050069
- Zaidi M, Premkumar G, Naqvi R, Khashkhusha A, Aslam Z, Ali A, et al. Aortic valve surgery: management and outcomes in the paediatric population. Eur J Pediatr. 2021;180(10):3129-39. Doi: https://doi.org/10.1007/S00431-021-04092-1.
- Hénaut L, Candellier A, Huish S, Issa N, Sinha S, Massy ZA. Valvular calcification in chronic kidney disease: new insights from recent clinical and preclinical studies. Clin Kidney J. 2025;18(Suppl 1):i27-45. Doi: https://doi.org/10.1093/ckj/sfae421.
- Singh S, Rutkowski PS, Dyachkov A, Iyer VS, Pourafkari L, Nader ND. A discrepancy between CT angiography and transesophageal echocardiographic measurements of the annular size affect long-term survival following trans-catheter aortic valve replacement. J Cardiovasc Thorac Res. 2021;13(3):245-5. Doi: https://doi.org/10.34172/jcvtr.2021.39.
- Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J, et al. 2021 ESC/EACTS Guidelines for the Management of Valvular Heart Disease. Eur. Heart J. 2022, 43, 561–632, Doi: https://doi.org/10.1093/eurheartj/ehab395.
- Cakir M, Kablan EB, Ekinci M, Sahin M. A new aortic valve calcium scoring framework for automatic calcification detection in echocardiography. J Imaging Inform Med. 2026,39:1906-24. Doi: https://doi.org/10.1007/s10278-025-01576-6.
- Abdulqader S, Bakr GM, Ahmed SA, Hassan QA, Al-Kinani M. Gender distribution of coronary artery calcium score and degree of stenosis assessed by computed tomography angiography in Iraqi patients with chest pain. Al-Rafidain J Med Sci. 2024;7(1):78-84. Doi: https://doi.org/10.54133/ajms.v7i1.1032.
- Yaseen M, Akram N, Nori W. Intravascular foreign bodies retrieval: navigating differences from childhood to adulthood. Scr Med (Brno). 2025;56(1):69-76. Doi: https://doi.org/10.5937/scriptamed56-53482.



