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Acute and long‐term outcomes of percutaneous balloon aortic valvuloplasty for the treatment of severe aortic stenosis
Author(s) -
Daniec Marzena,
Nawrotek Bartłomiej,
Sorysz Danuta,
Rakowski Tomasz,
Dziewierz Artur,
Rzeszutko Łukasz,
Kleczyński Paweł,
Trębacz Jarosław,
Tomala Marek,
Żmudka Krzysztof,
Dudek Dariusz
Publication year - 2017
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.26697
Subject(s) - medicine , aortic valvuloplasty , ejection fraction , cardiology , cardiogenic shock , interquartile range , stenosis , aortic valve replacement , balloon , aortic valve , ventricle , aortic valve stenosis , surgery , myocardial infarction , heart failure
Objectives This study aimed to evaluate the indications, short‐ and long‐term outcomes of balloon aortic valvuloplasty (BAV) in patients with severe aortic stenosis (AS). Methods A cohort of 112 patients with AS underwent 114 BAV procedures between October 2012 and July 2015 in two Polish interventional cardiology centers. Clinical and echocardiographic data were prospectively collected within 1, 6, and 12 months follow‐up. Results BAV was performed as a bridge to TAVI (51.8%), surgical aortic valve replacement (AVR, 5.4%), before urgent noncardiac surgery (8.0%), for symptom relief (33.0%) and cardiogenic shock (1.8%). Periprocedural, in‐hospital, 1‐, 6‐, 12‐month mortality were 2.7%; 8.9%; 8.9%; 16.9%; 22.3%, respectively. Serious periprocedural adverse events occurred in 18.8% of patients. After the procedure, mean aortic valve area (AVA) increased from 0.59 ± 0.18 to 0.82 ± 0.24 cm 2 , mean peak aortic valve gradient (pAVG) decreased from 94.0 ± 27.6 to 65.4 ± 20.0 mm Hg, mean aortic gradient decreased from 58.0 ± 17.8 to 40.5 ± 14.6 mm Hg, P < 0.05 for all. Left ventricular ejection fraction (LVEF) increased from median (interquartile range) of 53.5 (30 − 64) to 60 (45 − 65)% after 1 month ( P < 0.05). In patients with impaired left ventricle function (LVEF <40%), LVEF significantly improved (median increase of 16%) after 1 and 6 months ( P < 0.05). At 12 months patients had higher AVA, pAVG, and LVEF as compared to baseline ( P < 0.05). Conclusions BAV is a useful procedure in high‐risk AS patients, where achieved effects can be sufficient in bridging patients for TAVI/AVR. © 2016 Wiley Periodicals, Inc.