ArticleBMJ open2023
Volume-outcome relationship in balloon aortic valvuloplasty: results of a consecutive, patient-level data analysis from a Japanese nationwide multicentre registry (J-SHD).
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 4 citations in OpenAlex.
- Efficacy and safety of emergent balloon aortic valvuloplasty as a rescue therapy for cardiogenic shock due to severe aortic stenosis in non-TAVI centers.BMC cardiovascular disorders · 2025Article
- Immunotherapy in the Context of Aortic Valve Diseases.Cardiovascular drugs and therapy · 2024Review
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11 authors at 9 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveTranscatheter balloon aortic valvuloplasty (BAV) remains an important alternative treatment for severe, symptomatic aortic stenosis. With increasing numbers of BAVs being performed, the need for large-scale volume-outcome relationship assessments has become evident. Here, we aimed to explain such relationships by analysing consecutive, patient-level BAV data recorded in a prospective Japanese nationwide multicentre registry.
designProspective study.
settingData of 1920 BAVs performed in 200 Japanese hospitals from January 2015 to December 2019.
participantsThe mean patient age was 85 years, and 36.9% of procedures involved male patients.
methodsThe efficacy of BAV was assessed by reducing the mean transaortic valve gradient after the procedure. We also assessed in-hospital complication rates, including in-hospital death, bleeding, urgent surgery, distal embolism, vessel rupture and contrast-induced nephropathy. Based on the distribution of case volume (median 20, IQR 10-46), we divided the patients into high-volume (≥20) and low-volume (<20) groups. In-hospital complication risk was assessed with adjustment by logistic regression modelling.
resultsIndications for BAV included palliative/destination (44.2%), bridge to transcatheter aortic valve replacement (34.5%), bridge to surgical aortic valve replacement (7.4%) and salvage (9.7%). Reduction of the mean transaortic valve gradient was similar between the high-volume and low-volume groups (20 mm Hg vs 20 mm Hg, p=0.12). The proportion of in-hospital complications during BAV was 4.2%, and the incidence of complications showed no difference between the high-volume and low-volume groups (4.2% vs 4.1%, p=1.00). Rather than hospital volume, salvage procedure was an independent predictor of in-hospital complications (OR, 4.04; 95% CI, 2.03 to 8.06; p<0.001).
conclusionThe current study demonstrated that procedural outcomes of BAV were largely independent of its institutional volume.
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