Document Detail


Balloon aortic valvuloplasty in adults--a 10-year review of Auckland's experience.
MedLine Citation:
PMID:  18753007     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients with severe aortic stenosis, ineligible for surgical aortic valve replacement (AVR), may instead be offered balloon aortic valvuloplasty (BAV). However, initial international enthusiasm for BAV has waned due to early restenosis and symptom recurrence. METHODS: We retrospectively reviewed consecutive adult patients who had BAVs in Auckland over a 10-year period from 1997 to 2006 and recorded their clinical, echocardiographic, haemodynamic and follow-up data. RESULTS: Twenty-nine patients (17F) underwent 35 BAV procedures. There were 26 elderly patients (mean age 87; median logistic EuroSCORE 26%) and 3 patients requiring "bridging" prior to intended AVR at a later interval. Mean changes in left ventricular systolic pressure, aortic systolic pressure and mean gradient were -8%, +16% and -43%, respectively. In the 26 elderly patients, median time to death or recurrence of symptoms was nine months. There was a significant reduction in the number of cardiac-related admissions six months after BAV compared to six months before (p=0.02). Actuarial survival of the elderly patients at 6 months, 1 year and 2 years was 88%, 64%, 31%, respectively. Complications of BAV were 2 reversible neurological events, 2 haematomas and 1 pseudoaneurysm. Re-do BAVs in 5 patients on >or=2 occasions resulted in an improved median actuarial survival of 36 months. CONCLUSION: In our experience, BAV has a useful role in symptom palliation in severe aortic stenosis when surgical valve replacement is declined or inappropriate, and can be performed in selected patients with relatively few complications. Re-do BAVs in suitable patients may prolong symptom relief and survival.
Authors:
Andrew C Y To; Irene Zeng; H Arthur Coverdale
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-08-26
Journal Detail:
Title:  Heart, lung & circulation     Volume:  17     ISSN:  1444-2892     ISO Abbreviation:  Heart Lung Circ     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-21     Completed Date:  2009-03-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100963739     Medline TA:  Heart Lung Circ     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  468-74     Citation Subset:  IM    
Affiliation:
Green Lane Cardiovascular Service, Auckland City Hospital, Park Road, Grafton, Auckland, New Zealand. andrewcyto@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Valve Stenosis / therapy*
Balloon Dilatation*
Female
Follow-Up Studies
Frail Elderly
Humans
Kaplan-Meiers Estimate
Male
New Zealand
Palliative Care
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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