Search for: [Abstract = "Aortic stenosis \(AS\) is the most frequent acquired valve disease indeveloped countries. The prevalence of AS in the elderly \(>75 yearsold\) is 12.4% of whom 3.4% have severe AS. Severe symptomatic ASis associated with a poor prognosis, as most patients die within 2–3years of diagnosis. Aortic valve replacement \(AVR\) is the preferred treatment of symptomatic AS but unavailable for many patients due to high procedural risk. Transcatheter aortic valve implantation \(TAVI\)and balloon aortic valve valvuloplasty \(BAV\) are less invasiveprocedures as compared to surgery. TAVI is now given particularprominence in the group of high\-risk patients as an acceptablealternative to AVR, with reported improvement in the quality of lifeand clinical outcomes. According to the European Society ofCardiology \(ESC\) guidelines for the management of valvular heart disease, BAV may be considered as a bridge to surgery or TAVI inhaemodynamically unstable patients who are at high risk for surgery,or in patients with symptomatic severe AS who require urgent major non\-cardiac surgery \(Class IIb, Level C\). BAV may also be consideredas a palliative procedure in selected cases when both surgery andTAVI are contraindicated because of severe comorbidities. BAV maybe especially beneficial in those patients leading to temporaryimprovement of LVEF and requalification to TAVI\/AVR. Etiology of degenerative AS reveals similarities to the etiology ofCAD in inflammatory and calcific processes. Therefore, in almost halfof the patients aged ≥70 years, newly diagnosed AS coexists withCAD. The ESC guidelines recommend to perform coronaryangiography before valvular heart surgery in case of any of thefollowing\: history of CAD, suspected myocardial ischaemia, leftventricular systolic dysfunction, in men >40 years andpostmenopausal women, or in patients with ≥1 cardiovascular riskfactor \(Class I, Level C\). In patients with a primary indication foraortic valve surgery, coronary artery bypass grafting \(CABG\) remains the preferred treatment of CAD if coronary artery diameter stenosis is≥70% \(Class I, Level C\). Therefore, until recently, the standardtreatment option for patients with severe AS and concomitant CAD was AVR combined with CABG. After the introduction of TAVI, newcomplex models of treatment have been developed with the additionaluse of percutaneous coronary intervention \(PCI\) together with BAV.Nowadays patients with significant CAD scheduled for BAV\/TAVIcan be treated with PCI at the time of BAV\/TAVI \(as a singleprocedure\) or with staged PCI. The post\-implantation paravalvularleak \(PVL\) remains an important TAVI\-related complication worsening clinical outcomes. PVL is present in up to 70% of all patients undergoing TAVI, and more than mild PVL has been reported in approximately 10–15% patients. Angiography and echocardiography are the primary tools to quantify the degree of PVL.Balloon post\-dilatation \(PD\) can reduce PVL by achieving a better expansion of the prosthesis and optimal sealing of the paravalvularspace.AimThe aim of this study was to determine procedural and clinicaloutcomes of patients with severe AS undergoing standalone BAV orBAV with coronary angiography\/PCI and to evaluate the effects of balloon PD on the reduction of PVL and mortality in patients undergoing TAVI."]

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