What is the clinical evidence from this study?

Study design: Observational. Population: Cardiogenic shock due to severe aortic stenosis (n=21). Intervention: Percutaneous aortic balloon valvuloplasty. Primary outcome: Kaplan-Meier survival rate at 27 months.

What question did this study set out to answer?

Evaluate percutaneous aortic valvuloplasty's role in cardiogenic shock from severe aortic stenosis and identify survival predictors.

June 26, 2026

The role of percutaneous aortic balloon valvuloplasty in patients with cardiogenic shock and critical aortic stenosis

Key Result

Percutaneous aortic balloon valvuloplasty in patients with cardiogenic shock and severe aortic stenosis resulted in a 57% in-hospital survival and a 38% Kaplan-Meier survival rate at 27 months.

Key Points

Evaluate percutaneous aortic valvuloplasty's role in cardiogenic shock from severe aortic stenosis and identify survival predictors.
Analyzed data from 310 patients undergoing percutaneous aortic balloon valvuloplasty, focusing on 21 cases in cardiogenic shock.
Assessments included changes in systolic aortic pressure, aortic valve area, and cardiac index pre-and post-procedure.
Systolic aortic pressure increased from 77 to 116 mm Hg (p=0.0001).
Aortic valve area improved from 0.48 to 0.84 cm2 (p=0.0001).
12 patients (57%) survived after follow-up for 15 months, with a 38% survival rate at 27 months.

Study Design

Type

Observational (n=21)

Structured PICO

Does percutaneous aortic balloon valvuloplasty improve hemodynamics and survival in patients with cardiogenic shock and critical aortic stenosis?

Population

21 patients with cardiogenic shock, severe aortic stenosis, and major comorbid conditions undergoing percutaneous aortic balloon valvuloplasty, followed for a mean of 15 months.

Exposure

Percutaneous aortic balloon valvuloplasty

Outcome

Survival and hemodynamic improvement (systolic aortic pressure, aortic valve area, cardiac index)hard clinical

Emergency percutaneous aortic balloon valvuloplasty can serve as a lifesaving procedure and therapeutic alternative for nonsurgical patients with critical aortic stenosis and cardiogenic shock, despite high residual mortality.

Abstract

OBJECTIVES: The goal of this study was to evaluate the role of percutaneous aortic valvuloplasty in patients with cardiogenic shock due to severe aortic stenosis and associated major comorbid conditions and to establish predictors of survival. BACKGROUND: The prognosis for patients in cardiogenic shock with severe aortic stenosis is poor. Aortic valve replacement can be lifesaving, but the presence of multiorgan failure precludes these patients from operation. Percutaneous aortic balloon valvuloplasty has been used in these patients with short-term improvement and could be an alternative therapeutic option. METHODS: Of 310 patients undergoing percutaneous aortic balloon valvuloplasty, 21 were in cardiogenic shock and were included in this study. All 21 patients had associated major comorbid conditions at the time of presentation. RESULTS: After percutaneous aortic balloon valvuloplasty, systolic aortic pressure increased from 77 +/- 3 (mean +/- SEM) to 116 +/- 8 mm Hg (p = 0.0001); aortic valve area increased from 0.48 +/- 0.04 to 0.84 +/- 0.06 cm2 (p = 0.0001); and cardiac index increased from 1.84 +/- 0.13 to 2.24 +/- 0.15 liters/min per m2 (p = 0.06). Nine patients died in the hospital, two during the procedure and seven after successful percutaneous aortic balloon valvuloplasty (five from multiorgan failure). Five patients had vascular complications. Stroke, cholesterol emboli and aortic regurgitation requiring aortic valve replacement occurred in one patient each. Twelve patients (57%) survived and were followed up for 15 +/- 6 months; five patients subsequently died. The Kaplan-Meier survival curve showed a 38 +/- 11% survival rate at 27 months. The only predictor for longer survival rate was the postprocedure cardiac index. CONCLUSIONS: 1) Emergency percutaneous aortic balloon valvuloplasty can be performed successfully as a lifesaving procedure. 2) Morbidity and mortality remain high despite successful percutaneous aortic balloon valvuloplasty. 3) For nonsurgical candidates, percutaneous aortic balloon valvuloplasty may be the only therapeutic alternative.

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