Balloon aortic valvuloplasty in patients with severe aortic stenosis resulted in a 12-month mortality of 22.3% and significantly increased mean aortic valve area from 0.59 to 0.82 cm2 (P<0.05).
Cohort (n=112)
Yes
Does percutaneous balloon aortic valvuloplasty improve echocardiographic parameters and serve as a bridge to definitive therapy in patients with severe aortic stenosis?
Balloon aortic valvuloplasty is a useful bridging procedure in high-risk patients with severe aortic stenosis, significantly improving echocardiographic parameters and LVEF.
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.
Daniec et al. (Fri,) conducted a cohort in severe aortic stenosis (n=112). Balloon aortic valvuloplasty was evaluated on 12-month mortality. Balloon aortic valvuloplasty in patients with severe aortic stenosis resulted in a 12-month mortality of 22.3% and significantly increased mean aortic valve area from 0.59 to 0.82 cm2 (P<0.05).