| Patients with small left ventricular size undergoing balloon aortic valvuloplasty have worse intraprocedural outcomes. | |
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MedLine Citation:
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PMID: 22926957 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVES: To evaluate the impact of left ventricular (LV) chamber size on procedural and hospital outcomes of patients undergoing aortic valvuloplasty. BACKGROUND: Balloon aortic valvuloplasty (BAV) is used as an integral step during transcatheter aortic valve implantation. Patients with small, thickened ventricles are thought to have more complications during and following BAV. METHODS: Retrospective study of consecutive patients with severe, symptomatic calcific aortic stenosis who underwent retrograde BAV at Massachusetts General Hospital. We compared patients with left ventricular end-diastolic diameters (LVEDD) <4.0 cm (n = 31) to those with LVEDD ≥4.0 cm (n = 78). Baseline and procedural characteristics as well as clinical outcomes were compared. Multivariate logistic regression was used for the adjusted analysis. RESULTS: Patients with smaller LV chamber size were mostly women (80.7% vs. 19.4%, P < 0.01) and had a smaller body surface area (BSA), (1.61 ± 0.20 m(2) vs. 1.79 ± 0.25 m(2) , P < 0.01). Patients with smaller LV chamber size had higher ejection fractions and thicker ventricles. Otherwise, baseline characteristics were similar. The intraprocedural composite of death, cardiopulmonary arrest, intubation, hemodynamic collapse, and tamponade was higher for patients with LVEDD < 4.0 cm (32.3% v. 11.5%, P = 0.01). Adjusting for age, gender, BSA, LV pressure, and New York Heart Association class, LVEDD < 4.0 cm remained an independent predictor of procedural (OR 5.1, 95% CI 1.4-18.2) and in-hospital complications (OR 3.8, 95% CI 1.2-11.6). CONCLUSIONS: Compared to patients undergoing BAV with LVEDD ≥4.0 cm, those with smaller LV chambers had worse procedural and in-hospital outcomes. © 2012 Wiley Periodicals, Inc. |
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Authors:
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Creighton Don; Pritha P Gupta; Christian Witzke; Manoj Kesarwani; Roberto J Cubeddu; Ignacio Inglessis; Igor F Palacios |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-8-23 |
Journal Detail:
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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 Aug |
Date Detail:
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Created Date: 2012-8-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Wiley Periodicals, Inc. |
Affiliation:
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Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Division of Cardiology, University of Washington Medical Center, Seattle, Washington. cwdon@u.washington.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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