Indications and Utility of Percutaneous Balloon Aortic Valvuloplasty in Older Adults

Balloon aortic valvuloplasty (BAV) was originally considered as an alternative to surgery for the treatment of aortic stenosis. However, due to the poor durability of its effects, it was largely relegated to palliative use. Recently, there has been increased application of BAV, particularly as a bridging procedure to transcatheter aortic valve replacement (TAVR) therapy. Furthermore, stand-alone BAV is now more frequently employed as palliative procedure for the growing population of older adults with aortic stenosis (AS) with limited life expectancy. Accordingly, BAV use has increased both in the USA and other countries, and this trend is expected to continue. The purpose of this review is to document trends in BAV use, data on effectiveness, and considerations in frail older adults in contemporary medical practice.