Predilatation prior to transcatheter aortic valve implantation: Is it still a prerequisite?

Matteo Pagnesi, Luca Baldetti, Paolo Del Sole, Antonio Mangieri, Marco B. Ancona, Damiano Regazzoli, Nicola Buzzatti, Francesco Giannini, Antonio Colombo, Azeem Latib

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Predilatation has been historically considered a mandatory step before transcatheter aortic valve implantation (TAVI) since it facilitates valve crossing and prosthesis delivery, ensures optimal valve expansion and improves hemodynamic stability during valve deployment. However, as a result of procedural evolution over time, direct TAVI (without pre-implantation balloon aortic valvuloplasty) has emerged as an interesting option to simplify the procedure and to avoid potential valvuloplasty-related complications. Several real-world retrospective studies and one small randomised study have shown that direct TAVI (with both self-expanding and balloon-expandable prostheses) is feasible, safe and associated with outcomes similar to standard TAVI with pre-implantation balloon aortic valvuloplasty. In the absence of high-quality, robust evidence, the current review aims to discuss the advantages and disadvantages of omitting predilatation prior to TAVI.

Original languageEnglish (US)
Pages (from-to)116-125
Number of pages10
JournalInterventional Cardiology Review
Issue number2
StatePublished - 2017
Externally publishedYes


  • Aortic valve calcification
  • Balloon aortic valvuloplasty
  • Cerebral embolic risk
  • Direct transcatheter aortic valve implantation
  • Paravalvular leakage
  • Permanent pacemaker
  • Postdilatation
  • Predilatation
  • Transcatheter aortic valve implantation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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