When would you consider performing direct implantation versus prior dilatation with balloon aortic valvuloplasty during TAVR?   

Severe calcification of the aortic valve and Valve area less than 0.5 cm² or very high gradients, which could cause difficulty of the TAVR valve to cross the native aortic valve. Bicuspid aortic valve with severe calcification. If the coronary heights are borderline low, concerning for post...

We usually decide based on valve calcium score, and ease of crossing the valve during the procedure literally "the way the wire looks and crosses" the valve. overall, we do a pre-BAV about 10% of the time or less during the procedure. most other times we don't.  I believe less is more. BAV is ...

Elective BAV prior to TAVR is a rarity and reserved predominantly for palliative and bridging purposes. Same setting BAV is not a rarity, but is nonetheless less common, and often considered unnecessary manipulation of a degenerated AV, increasing the risk of CVA.  It is best reserved for; ...

In patients who need to be bridged for TAVR.