True Flow balloon valvuloplasty catheter

Aortic balloon valvuloplasty requires rapid cardiac pacing with a pacemaker to avoid the balloon moving while it is inflated and causing injury to the leaflets or even the annulus if it slips uncontrollably. In addition, during valvuloplasty, the inflated balloon (inflated for approximately 5 s) causes left ventricular outflow tract obstruction and ischemia, which in some patients may cause significant hemodynamic compromise.

True Flow (Bard, USA) is a valvuloplasty balloon catheter that allows continued blood flow while it is inflated. It has an outer fiber-based shell that prevents the balloon from sliding when it is opened onto the valve leaflets, so a pacemaker is not required. This shell is made of high-molecular weight polyurethane, polyester and aramid fibers (a structural component of Kevlar) and has minimal stretch and high resistance to rupture. The inside of the balloon has 8 small balloons around the edge of the main balloon, with an inner lumen between them where blood can flow. The device measures 3.5 cm long and is available in six sizes, with diameters from 18 mm to 26 mm. The smaller models are compatible with an 11 Fr sheath and the largest, with a 16 Fr sheath.

This type of balloon catheter allows valvuloplasty to be performed for 60 s or more without rapid pacing, with a 1/3 reduction in the mean aortic pressure while the balloon is inflated, which means a 50% reduction in the aortic gradient. This could be especially useful in patients with severe dysfunction.

Palabras clave: valvuloplastia aórtica, balón de valvuloplastia. Keywords: aortic valvuloplasty, valvuloplasty balloon.