Document Detail

Patients with small left ventricular size undergoing balloon aortic valvuloplasty have worse intraprocedural outcomes.
MedLine Citation:
PMID:  22926957     Owner:  NLM     Status:  MEDLINE    
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.
Creighton Don; Pritha P Gupta; Christian Witzke; Manoj Kesarwani; Roberto J Cubeddu; Ignacio Inglessis; Igor F Palacios
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2012-08-23
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  80     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-20     Completed Date:  2013-05-06     Revised Date:  2014-10-02    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  946-54     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
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MeSH Terms
Aged, 80 and over
Aortic Valve / pathology,  physiopathology
Aortic Valve Stenosis / complications,  diagnosis,  physiopathology,  therapy*
Balloon Valvuloplasty / adverse effects*
Body Surface Area
Calcinosis / complications,  diagnosis,  physiopathology,  therapy*
Heart Ventricles* / physiopathology,  ultrasonography
Hospitals, General
Hypertrophy, Left Ventricular / diagnosis,  etiology*,  physiopathology
Linear Models
Logistic Models
Multivariate Analysis
Odds Ratio
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Stroke Volume
Treatment Outcome
Ventricular Function, Left
Grant Support
Comment In:
Catheter Cardiovasc Interv. 2012 Nov 15;80(6):955   [PMID:  23166100 ]

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