# Preoperative Balloon Aortic Valvuloplasty in a Nonagenarian With Oral Cancer and Severe Aortic Stenosis: A Case Report

## TL;DR

A 90-year-old woman with severe heart valve disease and mouth cancer successfully underwent heart valve treatment before cancer surgery, which is a new approach in elderly patients.

## Contribution

This is the first documented case of successful gingival cancer surgery following preoperative balloon aortic valvuloplasty in an elderly patient.

## Key findings

- Balloon aortic valvuloplasty enabled safe cancer surgery in a nonagenarian with severe aortic stenosis.
- The staged approach allowed tumor resection with adequate surgical margins and lymph node clearance.
- No major adverse events occurred, suggesting BAV may be a viable option for similar high-risk patients.

## Abstract

The concurrent presence of valvular heart disease and malignancy poses significant therapeutic challenges, particularly in patients of advanced age. Balloon aortic valvuloplasty (BAV) represents one potential option for addressing critical aortic valve disease before oncological intervention, though optimal patient selection criteria remain debated. We present a 90-year-old woman in whom echocardiographic evaluation prior to planned gingival cancer surgery revealed hemodynamically significant aortic valve narrowing. Following multidisciplinary consultation with cardiologists and anesthesiologists, BAV was performed 48 hours prior to the oncological procedure. The valve intervention produced sufficient hemodynamic improvement to permit definitive tumor resection with adequate surgical margins, including prophylactic lymph node clearance. Hospital discharge occurred approximately four weeks postoperatively without major adverse events. To the best of our knowledge, this is the first documented instance of a gingival malignancy resection following BAV. Our experience suggests that BAV may enable curative cancer surgery in carefully selected elderly patients with critical valvular disease who would otherwise face prohibitive operative risk. Nonetheless, additional evidence is necessary to define the appropriate role and safety profile of this staged therapeutic approach.