PMID- 20500543
OWN - NLM
STAT- MEDLINE
DCOM- 20101208
LR  - 20161125
IS  - 1540-8183 (Electronic)
IS  - 0896-4327 (Linking)
VI  - 23
IP  - 4
DP  - 2010 Aug
TI  - Aortic balloon valvuloplasty: is there still a role in high-risk patients in the 
      era of percutaneous aortic valve replacement?
PG  - 358-61
LID - 10.1111/j.1540-8183.2010.00559.x [doi]
AB  - OBJECTIVES: To assess procedural and clinical outcomes in adults with severe 
      aortic stenosis (AS) undergoing percutaneous aortic balloon valvuloplasty (PABV), 
      who are considered unsuitable on initial assessment for surgical aortic valve 
      replacement or transcatheter aortic valve implantation (TAVI). BACKGROUND: 
      Surgical valve replacement provides better outcomes than conservative treatment 
      for patients with severe symptomatic AS; however, patients with multiple 
      comorbidities or hemodynamic instability carry a high operative risk. While TAVI 
      offers an alternative to surgery, not all patients are suitable. This study looks 
      at medium-term outcomes in a series of high-risk patients undergoing PABV. 
      METHODS: Pre- and postprocedure aortic valve gradients were measured by 
      catheterization and echocardiography. Patients were assessed for symptomatic 
      benefit and clinical outcomes. RESULTS: Over 4 years, 42 patients underwent PABV. 
      Mean clinical follow-up was 8 +/- 5.8 months and survival was 63%. Mean 
      echocardiographic aortic valve gradient fell from 84.6 +/- 27 mmHg to 51.3 +/- 16 
      mmHg (p < 0.05). In 29% (12/42) patients, PABV was performed as a bridge to 
      definitive AVR. Four had surgical AVR and six had TAVI. Two had successful 
      noncardiac surgery. Four patients died in the periprocedural period and all were 
      in cardiogenic shock. Patients were in New York Heart Association (NYHA) class IV 
      decreased from 60% to 5% postprocedure (p < 0.05). CONCLUSION: PABV is useful as 
      a palliation or bridge to definitive therapy for treatment of patients with 
      severe AS unsuitable for surgery. It is associated with good medium-term cardiac 
      outcomes and enables some patients to receive definitive therapy.
FAU - Hamid, Tahir
AU  - Hamid T
AD  - Manchester Heart Centre, Manchester Royal Infirmary, University of Central 
      Manchester, Foundation NHS Trust, United Kingdom. Tahirhamid76@yahoo.co.uk
FAU - Eichhofer, Jonas
AU  - Eichhofer J
FAU - Clarke, Bernard
AU  - Clarke B
FAU - Mahadevan, Vaikom S
AU  - Mahadevan VS
LA  - eng
PT  - Journal Article
DEP - 20100525
PL  - United States
TA  - J Interv Cardiol
JT  - Journal of interventional cardiology
JID - 8907826
SB  - IM
MH  - Aged
MH  - Aortic Valve/diagnostic imaging/surgery
MH  - Aortic Valve Insufficiency/diagnostic imaging/therapy
MH  - Aortic Valve Stenosis/mortality/*therapy
MH  - *Catheterization
MH  - Comorbidity
MH  - Echocardiography
MH  - Female
MH  - Heart Valve Prosthesis/statistics & numerical data
MH  - Heart Valve Prosthesis Implantation/methods
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - Stroke Volume
EDAT- 2010/05/27 06:00
MHDA- 2010/12/14 06:00
CRDT- 2010/05/27 06:00
PHST- 2010/05/27 06:00 [entrez]
PHST- 2010/05/27 06:00 [pubmed]
PHST- 2010/12/14 06:00 [medline]
AID - JOIC559 [pii]
AID - 10.1111/j.1540-8183.2010.00559.x [doi]
PST - ppublish
SO  - J Interv Cardiol. 2010 Aug;23(4):358-61. doi: 10.1111/j.1540-8183.2010.00559.x. 
      Epub 2010 May 25.