PMID- 26232015
OWN - NLM
STAT- MEDLINE
DCOM- 20161213
LR  - 20161230
IS  - 1557-2501 (Electronic)
IS  - 1042-3931 (Linking)
VI  - 27
IP  - 8
DP  - 2015 Aug
TI  - The Efficacy and Safety of Antegrade Inoue-Balloon Aortic Valvuloplasty to Treat 
      Calcific Critical Aortic Stenosis.
PG  - 373-80
AB  - BACKGROUND: Critical aortic stenosis (AS) with severe calcific degeneration often 
      resists conventional retrograde percutaneous balloon aortic valvuloplasty (PBAV). 
      To enhance therapeutic efficacy, a novel PBAV technique has been developed by 
      utilizing a single Inoue balloon via an antegrade approach, performing multiple 
      inflations with step-up increases (M-PBAV) of balloon diameter to the size of the 
      surgical valve ring. PATIENTS AND METHODS: A total of 405 non-surgical patients 
      with critical AS were treated by M-PBAV and the acute therapeutic response and 
      long-term clinical course were evaluated; some patients underwent the procedure 
      on two or three occasions. RESULTS: In a total of 456 procedures, mean 
      transaortic valve pressure gradient improved from an initial 63.6 +/- 17.3 mm Hg to 
      22.7 +/- 8.9 mm Hg post PBAV (P<.01). Mean aortic valve area increased from an 
      initial 0.55 +/- 0.15 cm(2) to 0.98 +/- 0.20 cm(2) immediately after M-PBAV (P<.01). 
      Clinical symptoms (New York Heart Association [NYHA] class) improved over time. 
      Prior to M-PBAV, baseline NYHA class I-II was 9.1%, and NYHA class III-IV was 
      90.9%. At 12 months post M-PBAV, mortality was 17.1%, with repeat M-PBAV plus 
      surgical AVR at 12.7%, 10.5% NYHA class III-IV, and 59.6% NYHA class I-II. At 24 
      months post M-PBAV, mortality was 25.8%, with repeat PBAV plus surgical AVR at 
      19.0%, 8.8% NYHA class III-IV, and 46.2% NYHA class I-II. Adverse events related 
      to the procedure included critical AR (0.5%), cardiac tamponade (1.8%), 
      intraprocedure hemodynamic compromise requiring percutaneous cardiopulmonary 
      support (0.5%), and reversible cerebral ischemia (1.3%). No myocardial infarct or 
      vascular complications occurred. CONCLUSION: M-PBAV enhanced the therapeutic 
      efficacy and procedural safety of valvuloplasty to treat severely calcified 
      critical AS, and diversified its clinical roles.
FAU - Sakata, Yoshihito
AU  - Sakata Y
AD  - Department of Cardiology, Ikegami General Hospital, Ikegami 6-1-19, Ota, Tokyo 
      146-0082, Japan. sakatachicago@yahoo.co.jp.
FAU - Matsubara, Kenshun
AU  - Matsubara K
FAU - Tamiya, Seiji
AU  - Tamiya S
FAU - Hayama, Yasufumi
AU  - Hayama Y
FAU - Usui, Kazutane
AU  - Usui K
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Invasive Cardiol
JT  - The Journal of invasive cardiology
JID - 8917477
RN  - Aortic Valve, Calcification of
SB  - IM
MH  - Aged, 80 and over
MH  - Aortic Valve/*pathology
MH  - Aortic Valve Stenosis/complications/diagnosis/etiology/*therapy
MH  - Balloon Valvuloplasty/*methods
MH  - Calcinosis/complications/diagnosis/*therapy
MH  - Cardiac Catheterization/*methods
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Treatment Outcome
EDAT- 2015/08/02 06:00
MHDA- 2016/12/15 06:00
CRDT- 2015/08/02 06:00
PHST- 2015/08/02 06:00 [entrez]
PHST- 2015/08/02 06:00 [pubmed]
PHST- 2016/12/15 06:00 [medline]
PST - ppublish
SO  - J Invasive Cardiol. 2015 Aug;27(8):373-80.