August 1, 1995European Heart Journal
Balloon aortic valvuloplasty in elderly patients at high risk for surgery, or inoperable
Why the study?
Does balloon aortic valvuloplasty improve hemodynamics and survival in elderly patients (≥ 80 years) with severe aortic stenosis who are at high risk for surgery or inoperable?
Population
86 frail elderly patients ≥ 80 years with severe aortic stenosis who are at high risk for surgery or…
Design
Case_series
Follow-up
13 +/- 9 months
Authors
Discussion
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Implication
May offer hemodynamic relief in inoperable elderly patients with severe aortic stenosis; leaves open randomized comparison to TAVR or medical therapy.
Key Points
- To evaluate the immediate and 1-year clinical and hemodynamic outcomes of balloon aortic valvuloplasty in elderly patients aged 80 years or older with severe aortic stenosis.
- Assessed 86 patients aged ≥ 80 years (mean age 84 ± 3 years; 44% aged ≥ 85 years) undergoing balloon aortic valvuloplasty.
- Monitored hemodynamic parameters, procedural complications, and long-term outcomes over a mean follow-up of 13 ± 9 months.
- Aortic valve area increased from 0.53 to 0.96 cm² and mean gradient decreased from 68 to 26 mm Hg (P < 0.05), with 2 periprocedural deaths and no local vascular complications.
- During follow-up, 27 patients died, 4 required repeat balloon valvuloplasty, and 8 underwent surgical aortic valve replacement.
- The 1-year actuarial survival rate was 73%, and 78% of surviving patients maintained persistent clinical improvement.
Structured PICO
Does balloon aortic valvuloplasty improve hemodynamics and survival in elderly patients (≥ 80 years) with severe aortic stenosis who are at high risk for surgery or inoperable?
P
Population
86 frail elderly patients ≥ 80 years (mean age 84 +/- 3 years, 44% ≥ 85 years) with severe aortic stenosis who are at high risk for surgery or inoperable.
I
Intervention
Balloon aortic valvuloplasty
O
Outcome
Immediate hemodynamic results (mean gradient and valve area) and 1-year survival/clinical improvementhard clinical
Balloon aortic valvuloplasty provides significant immediate hemodynamic improvement and acceptable 1-year survival in frail elderly patients with severe aortic stenosis who are poor surgical candidates.
Cite This Study
ELTCHANTNOFF et al. (1995) studied this question.