Document Detail


Balloon aortic valvuloplasty for severe aortic stenosis as a bridge to transcatheter/surgical aortic valve replacement.
MedLine Citation:
PMID:  23015369     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: This study aimed to determine success- and complication rates after balloon aortic valvuloplasty (BAV) and the outcome of BAV as a standalone therapy versus BAV as a bridge to transcatheter/surgical aortic valve replacement (T/SAVR). BACKGROUND: The introduction of transcatheter aortic valve replacement (TAVR) has led to a revival in BAV as treatment for patients with severe aortic stenosis. METHODS: A cohort of 472 patients underwent 538 BAV procedures. The cohort was divided into two groups: BAV alone 387 (81.9%) and BAV as a bridge 85 (18.1%) to (n=65, TAVR; n=20, surgery). Clinical, hemodynamic, and follow-up mortality data were collected. RESULTS: There was no significant difference between the two groups in mean age (81.7±8.3 vs. 83.2±10.9 years, p=0.18), Society of Thoracic Surgeons score (13.1±6.2 and 12.4±6.4, p=0.4), logistic EuroSCORE (45.4±22.3 vs. 46.9±21.8, p=0.43), and other co-morbidities. The mean increase in aortic valve area was 0.39±0.25 in the BAV alone group and 0.42±0.26 in the BAV as a bridge group, p=0.33. The decrease in mean gradient was 24.1±13.1 in the BAV alone group vs. 27.1±13.8 in the BAV as a bridge group, p=0.06. During a median follow up of 183 days [54-409], the mortality rate was 55.2% (n=214) in the BAV alone group vs. 22.3% (n=19) in the BAV as a bridge group during a median follow-up of 378 days [177-690], p <0.001. CONCLUSION: In high-risk patients with aortic stenosis and temporary contraindications to SAVR/TAVR, BAV may be used as a bridge to intervention with good mid-term outcomes. © 2012 Wiley Periodicals, Inc.
Authors:
Itsik Ben-Dor; Gabriel Maluenda; Danny Dvir; Israel M Barbash; Petros Okubagzi; Rebecca Torguson; Joseph Lindsay; Lowell F Satler; Augusto D Pichard; Ron Waksman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-27
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Affiliation:
Division of Cardiology, MedStar Washington Hospital Center, Washington, DC.
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