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Feasibility of transcatheter intervention for severe aortic stenosis in patients ≥90 years of age: Aortic valvuloplasty revisited
Author(s) -
Pedersen Wes R.,
Klaassen Paul J.,
Boisjolie Charlene R.,
Pierce Talia A.,
Harris Kevin M.,
Lesser John R.,
Hara Hidehiko,
Mooney Michael R.,
Graham Kevin J.,
Kshettry Vibhu R.,
Goldenberg Irvin F.,
Priztker Marc R.,
Van Tassel Robert A.,
Schwartz Robert S.
Publication year - 2007
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.21161
Subject(s) - medicine , aortic valvuloplasty , perioperative , stenosis , cardiology , surgery , aortic valve replacement , balloon , population , aortic valve stenosis , environmental health
Objectives: The goals of this study were to determine the feasibility, safety, and early outcomes of balloon aortic valvuloplasty (BAV) for severe aortic stenosis in a nonagenarian population. Background: This very elderly population is expanding rapidly, has a high incidence of aortic stenosis, and uncommonly undergoes surgical aortic valve replacement. These patients may best be treated with a transcatheter approach due to comorbidities, surgical risk, and personal preference. Methods: We reviewed 31 consecutive patients ≥≥90 years of age who underwent BAV at our institution from July 2003 to August 2006 for data pertinent to patient characteristics, procedural techniques, and 30‐day outcomes. Results: Our patients had a mean age of 93 ± 3.0 years (90–101). The society of thoracic surgery risk score was 18.5 (±10.2) and logistic Euroscore was 35.8 (±19.3). Twenty‐five patients (81%) underwent retrograde BAV and 6 (19%) antegrade BAV. Five patients (16%) underwent combined BAV and coronary stenting. Overall mean aortic valve area increased from 0.52 cm 2 (±0.17) to 0.92 cm 2 (±0.22) and mean New York Heart Association (NYHA) functional class improved from 3.4 to 1.8. Intraprocedural mortality occurred in one patient (3.2%) and 30‐day mortality in three patients (9.7%). Conclusions: BAV can be carried out in high risk nonagenarian patients with an acceptable complication rate, low perioperative mortality, and early improvement in NYHA functional class. © 2007 Wiley‐Liss, Inc.