Why the study?
Does percutaneous balloon aortic valvuloplasty improve clinical and haemodynamic outcomes in patients unable to undergo aortic valve replacement?
Does percutaneous balloon aortic valvuloplasty improve clinical and haemodynamic outcomes in patients unable to undergo aortic valve replacement?
Percutaneous balloon aortic valvuloplasty provides satisfactory immediate haemodynamic and clinical improvement but has a high rate of symptom recurrence, limiting its role to short-term palliation for patients ineligible for aortic valve replacement.
The purpose of this study was to evaluate the immediate and long-term clinical and haemodynamic effects of Percutaneous Balloon Aortic Valvuloplasty (PBAV). Thirty-three procedures were performed in 27 patients, 11 males and 16 females with a mean age of 72 years. The peak to peak systolic gradient across the aortic valve decreased by 52%, from 67 +/- 24 mmHg to 31 +/- 15 mmHg (p < 0.0001) and the aortic valve area increased by 35%, from 0.48 +/- 0.16 to 0.67 +/- 0.21 cm2 (p < 0.001) after PBAV. There were no procedural deaths. Minor complications occurred in seven patients. Eighty-one per cent of patients (27 procedures) showed immediate symptomatic improvement, five remained symptomatic and one died in hospital before discharge. In a mean follow-up of 17 +/- 12 months (range six to 38 months), eight patients died due to congestive cardiac failure, six underwent repeat PBAV, three died due to noncardiac causes and three had recurrent symptoms controlled on medical therapy. Event free survival at 15 months was 43%. In conclusion PBAV produces a satisfactory immediate clinical and haemodynamic result, however, considering the high rate of symptom recurrence, this procedure has a beneficial role only in short-term palliation of severely symptomatic patients who are unable to undergo aortic valve replacement.
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Sathe et al. (1992) studied this question.
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