Document Detail


Outcomes of concomitant percutaneous coronary intervention and balloon aortic valvuloplasty.
MedLine Citation:
PMID:  21735514     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Coronary artery disease often coexists with severe aortic stenosis. The feasibility and safety of combined balloon aortic valvuloplasty (BAV) and percutaneous coronary intervention (PCI) are unknown. AIM: To compare outcomes and complications of combined BAV and PCI with BAV alone. METHODS: The study cohort consisted of 409 patients with severe aortic stenosis undergoing BAV from 1/2007 to 12/2010. Overall, 329 patients underwent BAV alone and 80 underwent concomitant PCI. Clinical and hemodynamic data, as well as acute and intermediate-term outcomes, were collected RESULTS: At the operator's discretion PCI was done before BAV in 66 (82.5%) and after in 14 (17.5%). Patients who underwent concomitant procedures had a higher incidence of prior stroke and a lower incidence of atrial fibrillation. Procedure time and fluoroscopic time were significantly greater in the BAV/PCI group, (90.0±36.6 vs. 72.8±39.8, p=0.002 and 20.5±10.9 vs. 12.9±7.0, p <0.001). Significantly more radiographic contrast was used in the BAV/PCI group (95.1±45.5 vs. 36.7±38.4 cc, p <0.001. Serious adverse events occurred with equal frequency 13.7% and 17.3%, p=0.44). Transfusion requirement was also similar (21.2% vs. 20.0%, p=0.81). The frequency of a periprocedural increase in troponin or creatinine was also similar. In the BAV alone group the mortality rate was 48.6% (n=160) during a mean follow-up of 191 days, and in the BAV/PCI group the mortality rate was 40% (n=32) during mean follow-up of 175.5 day, p=0.34. CONCLUSION: Combined BAV and PCI is safe and is associated with similar complications as BAV alone and may offer protection against myocardial ischemia during BAV. © 2011 Wiley-Liss, Inc.
Authors:
Itsik Ben-Dor; Gabriel Maluenda; Patrick M Looser; Petros Okubagzi; Rebecca Torguson; Zhenyi Xue; Joseph Lindsay; Lowell F Satler; Augusto D Pichard; Ron Waksman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-6
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-7     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 © 2011 Wiley-Liss, Inc.
Affiliation:
Division of Cardiology, Washington Hospital Center, Washington, DC.
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