Introduction
Balloon aortic valvuloplasty (BAV) was introduced as an alternative to
aortic valve replacement in 1986; it has played a limited role in the
treatment of patients with severe aortic stenosis (AS) owing to
complication risks, lack of durability, and its minor impact on
long-term survival.1, 2 However, in the era of
transcatheter aortic valve replacement (TAVR), BAV is frequently
utilized as a bridge procedure to TAVR for selected high-risk patients
who cannot be immediate candidates for TAVR; thus, acute effectiveness
and safety are required for BAV.3 Recently, the Inoue
balloon for use in retrograde BAV (Toray, Chuo-ku, Japan) was newly
invented. The hour-glass shaped balloon has multiple advantages,
including stable fixation and multistage inflation characteristics, and
therefore it does not impose any rapid ventricular pacing requirements
to fix the balloon position during inflation, compared with cylindrical
conventional balloons. We describe the BAV procedure which was safely
performed using the newly invented Inoue balloon for retrograde approach
in a high-risk patient.