Document Detail


Percutaneous balloon aortic valvuloplasty: antegrade transseptal vs. conventional retrograde transarterial approach.
MedLine Citation:
PMID:  15736255     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Percutaneous balloon aortic valvuloplasty (BAV) has been limited predominantly to a palliative treatment for poor surgical candidates with critical aortic stenosis and multiple high-risk or comorbid conditions. The most commonly used technique for BAV is the retrograde approach, in which the balloon is passed via the femoral artery using 12-14 Fr sheaths. We compared an antegrade transseptal approach using the Inoue balloon vs. the retrograde transarterial approach using conventional balloons. The antegrade group had an improved acute hemodynamic outcome, including 20% additional increase of aortic valve area and 20% greater reduction of transaortic valve gradient compared to the retrograde approach. Preclosure with the Perclose device was used for the 14 Fr venous access sites, resulting in immediate hemostasis, minimizing the need for transfusion, and diminishing the period of bed rest. The improved acute efficacy and relative ease of venous access for the antegrade approach facilitate BAV by eliminating the need for large-caliber arterial access sheaths. The antegrade approach also incorporates technical elements necessary for percutaneous aortic valve replacement and may have expanded applications as an adjunct to this developing therapy. The impact of improved acute results on the long-term clinical outcome for this patient group will require further study.
Authors:
Yoshihito Sakata; Zubair Syed; Michael H Salinger; Ted Feldman
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  64     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-03     Completed Date:  2005-07-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  314-21     Citation Subset:  IM    
Copyright Information:
Copyright 2005 Wiley-Liss, Inc.
Affiliation:
Evanston Northwestern Healthcare, Evanston, Illinois, USA.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Aortic Valve Stenosis / mortality,  therapy*,  ultrasonography
Balloon Dilatation / instrumentation,  methods*,  mortality
Echocardiography, Transesophageal
Equipment Design
Female
Femoral Artery
Femoral Vein
Follow-Up Studies
Heart Septum
Humans
Male
Palliative Care / methods
Retrospective Studies
Risk Factors
Survival Rate
Treatment Outcome

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


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