Percutaneous transluminal aortic valvuloplasty significantly decreased the aortic valve pressure gradient (P<0.00001) and provided palliation for patients with severe aortic stenosis unsuited for surgery.
Observational (n=18)
No
Does percutaneous transluminal aortic valvuloplasty improve survival and symptomatic status in patients with severe aortic stenosis who are not accepted for surgery?
Percutaneous transluminal aortic valvuloplasty provides significant hemodynamic and symptomatic improvement, serving as a viable palliative procedure for patients with severe aortic stenosis who are ineligible for surgical valve replacement.
OBJECTIVE: To determine the short-term and long-term results of percutaneous aortic valvuloplasty. DESIGN: A retrospective follow-up study. SETTING: The Cardiac Catheterisation Laboratory and Cardiovascular Medicine Unit of a teaching hospital. PATIENTS: Eighteen patients with severe aortic stenosis who were not accepted for surgery; there were 11 men and 7 women, mean age 79 +/- 4.5 years. INTERVENTIONS: Percutaneous transluminal aortic valvuloplasty (PTAV) by means of balloon catheter techniques. MAIN OUTCOME MEASURES: Patient survival and symptomatic status. RESULTS: PTAV resulted in a significant decrease in the aortic valve pressure gradient from 64.8 +/- 23.2 mmHg to 38 +/- 14.7 mmHg (mean +/- SD) (P less than 0.00001) in the 18 patients and a significant increase in the mean aortic valve area from 0.4 +/- 0.16 cm2 to 0.6 +/- 0.18 cm2 (P less than 0.0001) in 14 patients. Complications occurred in seven patients; two of them, who had been in terminal heart failure with a low output state before PTAV, died. Fifteen patients improved in at least one New York Heart Association functional class early after PTAV and one patient had an aortic valve replacement. In follow-up of between 5 and 32 months (mean, 13.3 +/- 7.7 months) six patients are in a better functional class than before PTAV, one patient is in Class IV, one patient had an aortic valve replacement and seven patients died (three died of cardiac failure and four of non-cardiac causes). CONCLUSIONS: PTAV has a place as a palliative procedure in selected patients with aortic stenosis in whom another condition precludes aortic valve replacement.
Alcaíno et al. (Wed,) conducted a observational in severe aortic stenosis (n=18). Percutaneous transluminal aortic valvuloplasty was evaluated on Patient survival and symptomatic status. Percutaneous transluminal aortic valvuloplasty significantly decreased the aortic valve pressure gradient (P<0.00001) and provided palliation for patients with severe aortic stenosis unsuited for surgery.
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