What is the clinical evidence from this study?

Study design: Observational. Population: Symptomatic aortic stenosis (n=26). Intervention: Percutaneous aortic balloon valvuloplasty vs. Before valvuloplasty (baseline). Primary outcome: Transvalvular gradient (mm Hg) (p=<0.0001).

What question did this study set out to answer?

To examine the morbidity, mortality, and hospital course of patients aged 80 years and older undergoing percutaneous aortic balloon valvuloplasty for symptomatic aortic stenosis.

May 15, 1989Annals of Internal Medicine

Percutaneous Aortic Balloon Valvuloplasty in Octogenarians: Morbidity and Mortality

Q: What are the key findings of this study?

Percutaneous aortic balloon valvuloplasty in octogenarians reduced the transvalvular gradient from 59 to 31 mm Hg (P<0.0001) and improved symptoms, but was associated with a 32% overall mortality.

Q: What question did this study set out to answer?

To examine the morbidity, mortality, and hospital course of patients aged 80 years and older undergoing percutaneous aortic balloon valvuloplasty for symptomatic aortic stenosis.

View Full Paper

Ask AI

Bookmark

Key result

Percutaneous aortic balloon valvuloplasty in octogenarians reduced the transvalvular gradient from 59 to 31 mm Hg (P<0.0001) and improved symptoms, but was associated with a 32% overall mortality.

Why the study?

Does percutaneous aortic balloon valvuloplasty improve hemodynamics and symptoms in patients aged 80 years or older with symptomatic aortic stenosis?

Population

26 patients aged 80 years or older with symptomatic aortic stenosis referred for balloon valvuloplasty.

Design

Case_series

Follow-up

6.1 months

Authors

SBStephen T. BradyUniversity of Pennsylvania

Discussion

Member takes

Implication

Palliative option in select octogenarians; leaves open role versus TAVR in contemporary practice.

Key Points

To examine the morbidity, mortality, and hospital course of patients aged 80 years and older undergoing percutaneous aortic balloon valvuloplasty for symptomatic aortic stenosis.
Retrospective consecutive case series of 26 patients aged 80 years or older (mean age, 86 years; 95% CI, 84 to 87) referred for balloon valvuloplasty at a tertiary referral hospital between July 1987 and July 1988.
Clinical follow-up was obtained at a mean of 6.1 months (95% CI, 4.1 to 8.1) in 19 eligible patients following hospital discharge.
Valvuloplasty significantly reduced transvalvular gradient from 59 mm Hg (95% CI, 51 to 67) to 31 mm Hg (95% CI, 26 to 35; P < 0.0001) and expanded valve area from 0.45 cm² (95% CI, 0.38 to 0.51) to 0.67 cm² (95% CI, 0.58 to 0.76; P < 0.0001).
Overall mortality reached 32% (2 in-hospital deaths presenting with cardiogenic shock and 5 post-discharge deaths), though 12 of 14 surviving patients improved by an average of 1.1 NYHA functional classes (95% CI, 0.7 to 1.4; P < 0.0001).
Procedural complications, shock, or surgery increased average hospital stays from 11.2 days to 16.2 days (95% CI, 6.2 to 26.2; P < 0.05) and raised charges from $29,600 to $44,400 (95% CI, 24,280 to 64,520; P < 0.01).

Study Design

Type

Observational (n=26)

Multicenter

Structured PICO

Does percutaneous aortic balloon valvuloplasty improve hemodynamics and symptoms in patients aged 80 years or older with symptomatic aortic stenosis?

Population

26 patients aged 80 years or older with symptomatic aortic stenosis undergoing percutaneous aortic balloon valvuloplasty, followed for an average of 6.1 months.

Exposure

Percutaneous aortic balloon valvuloplasty

Outcome

Morbidity, mortality, and hospital course (including transvalvular gradient, aortic valve area, length of hospital stay, and hospital charges)

Main Result

Absolute Event Rate: 31% vs 59%

p-value: p=<0.0001

Percutaneous aortic balloon valvuloplasty provides palliative hemodynamic and symptomatic improvement in octogenarians with symptomatic aortic stenosis, though it is associated with high overall mortality.

Cite This Study

Stephen T. Brady (1989) conducted an observational in Symptomatic aortic stenosis (n=26). Percutaneous aortic balloon valvuloplasty vs. Before valvuloplasty (baseline) was evaluated on Transvalvular gradient (mm Hg) (p=<0.0001). Percutaneous aortic balloon valvuloplasty in octogenarians reduced the transvalvular gradient from 59 to 31 mm Hg (P<0.0001) and improved symptoms, but was associated with a 32% overall mortality.

synapsesocial.com/papers/6a994972dea2d226f518fd68 https://doi.org/10.7326/0003-4819-110-10-761

View Full Paper

Ask AI

Bookmark

Percutaneous Aortic Balloon Valvuloplasty in Octogenarians: Morbidity and Mortality

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Percutaneous Aortic Balloon Valvuloplasty in Octogenarians: Morbidity and Mortality

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider