ABSTRACT
BALLOON AORTIC VALVULOPLASTY After its introduction in 1995 by Cribier, balloon aortic valvuloplasty (BAV) was rapidly adopted and experienced intense interest and explosive growth in 1986 and 1987 (1,2). The rapid recognition of restenosis in the majority of patients, and a clear appreciation for the lack of any improvement in the survival curve in the generally elderly patients targeted for this procedure led to as rapid a decline in its use (3-6). Ultimately, guideline recommendations directed the use of BAV only for high-risk patients for conventional surgery, for use as a bridge to conventional aortic valve replacement (AVR). What has been lost in this process is recognition of the value of BAV as a palliative procedure for patients who otherwise receive no specific therapy (7). There is a large population of patients for whom AVR surgery is extremely high risk. Many of these patients will decline surgery when referred, and many more are never referred because of their advanced age and/or comorbid conditions. There are as many patients in this high-risk category as there are who actually receive operation annually, and there is growing recognition that they may receive significant improvement in symptoms with the use of BAV (8).
