Document Detail


Effects of percutaneous aortic valve replacement on coronary blood flow assessed with transesophageal Doppler echocardiography in patients with severe aortic stenosis.
MedLine Citation:
PMID:  19733723     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to assess the change in coronary flow in patients who underwent percutaneous aortic valve replacement (PAVR) for severe aortic stenosis. The left main coronary artery was visualized using transesophageal echocardiography in 17 patients who underwent PAVR. The peak systolic and diastolic velocities of coronary flow and the time-velocity integral were obtained before and after PAVR using pulsed-wave Doppler. The median age was 80.0 years (interquartile range [IQR] 80.0 to 88.0). Median gradients decreased from 40.0 mm Hg (IQR 35.0 to 50.0) before PAVR to 4.0 mm Hg (IQR 2.75 to 4.2) afterward (p <0.001). Aortic valve area increased from 0.6 cm(2) (IQR 0.5 to 0.7) to 1.9 cm(2) (IQR 1.7 to 2.0) (p <0.001). Cardiac output increased from 3.3 L/min (IQR 2.4 to 4.0) to 3.6 L/min (IQR 3.1 to 4.4) (p <0.001). Aortic systolic pressure did not change significantly, from 126.0 mm Hg (IQR 11.7 to 137.7) before to 134 mm Hg (IQR 116.3 to 142.5) after valve implantation (p = 0.8). Left ventricular end-diastolic pressure decreased significantly from 19.0 mm Hg (IQR 18.0 to 22.0) before to 14.0 mm Hg (IQR 12.0 to 17.0) after valve implantation (p = 0.01). The medians of the following coronary flow parameters increased significantly after PAVR: peak systolic velocity, 25.0 cm/s (IQR 17.0 to 30.0) to 37.0 cm/s (IQR 23.0 to 44.0) (p <0.001); peak diastolic velocity, 49.0 cm/s (IQR 39.5 to 61.0) to 57.0 cm/s (IQR 42.9 to 83.9) (p = 0.006); total velocity-time integral, 23.7 cm (IQR 15.0 to 27.1) to 28.1 cm (IQR 21.3 to 34.7) (p = 0.001); and systolic velocity-time integral, 5.4 cm (IQR 3.5 to 6.2) to 9.0 cm (IQR 4.5 to 9.8) (p = 0.001). The diastolic time-velocity integral increased from 17.2 cm (IQR 12.0 to 24.0) to 20.1 cm (IQR 15.0 to 25.9) (p = 0.02). In conclusion, after PAVR, there is a significant increase in coronary flow as measured by peak systolic velocity, diastolic velocity, and velocity-time integral using pulsed-wave Doppler by transesophageal echocardiography.
Authors:
Itsik Ben-Dor; Steven A Goldstein; Ron Waksman; Lowell F Satler; Yanlin Li; Asmir I Syed; Gabriel Maluenda; Sara D Collins; William O Suddath; Rebecca Torguson; Zhenyi Xue; Kimberly Kaneshige; Petros Okubagzi; Zuyue Wang; Kenneth M Kent; Augusto D Pichard
Related Documents :
2228293 - Development of a new inflow valve for a 20cc semisoft ventricle: preliminary results.
22525003 - Comparison of non-invasive and implanted telemetric measurement of blood pressure and e...
18582263 - Pre-emptive novalung-assisted carbon dioxide removal in a patient with chest, head and ...
Publication Detail:
Type:  Journal Article     Date:  2009-07-18
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-07     Completed Date:  2009-09-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  850-5     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Washington Hospital Center, Washington, DC, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Valve Stenosis / physiopathology*,  surgery*
Balloon Dilatation
Blood Pressure
Blood Vessel Prosthesis Implantation* / methods
Cardiac Output
Coronary Circulation* / physiology
Echocardiography, Doppler, Pulsed
Echocardiography, Transesophageal*
Female
Humans
Male
Pilot Projects
Postoperative Period
Stroke Volume

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


Previous Document:  Effect of balloon valvuloplasty in patients with severe aortic stenosis on levels of N-terminal pro-...
Next Document:  Persistent tricuspid regurgitation and its predictor in adults after percutaneous and isolated surgi...