Document Detail


Revival of an old method with new techniques: balloon aortic valvuloplasty of the calcified aortic stenosis in the elderly.
MedLine Citation:
PMID:  18389165     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Balloon aortic valvuloplasty (BAV), introduced since almost 20 years, has experienced a revival for its use in the treatment of elderly patients with severe calcified aortic stenosis that are associated with high operative risk and co-morbidities. This is due to the introduction of new balloon catheters and techniques. This study reports about 75 such cases performed within the past 28 months. The mean age of our patient group was 78 +/- 7 years (median = 80 years). Risk calculation with the EuroSCORE demonstrated an average value of 24.4 +/- 19.5%. BAV was performed along with burst pacing to reduce transvalvular blood flow for stabilization of the balloon catheter until blood pressure dropped to less than 50 mmHg. BAV was performed in 72 patients with a procedural success rate of 73%. There was a decrease of 31 mmHg peak-to-peak gradient across the aortic valve from 63 +/- 35 to 32 +/- 22 mmHg (P < 0.0001). Mean gradient was reduced from 51 +/- 24 to 27 +/- 15 mmHg (P < 0.0001). Aortic valve area increased by 49% from 0.84 +/- 0.33 to 1.25 +/- 0.45 cm(2) (P < 0.0001). Serious adverse events (SAE) occurred in 17% of the 75 BAV procedures. Follow-up revealed a significant improvement in 6-month and 1-year survival. The improved technology of BAV makes this technique attractive for elderly patients who are at high operative risk or in cases where valve replacement was refused for any reason.
Authors:
Stefan Sack; Philipp Kahlert; Sasan Khandanpour; Christoph Naber; Sebastian Philipp; Stefan Möhlenkamp; Burkhard Sievers; Hagen Kälsch; Raimund Erbel
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-04-03
Journal Detail:
Title:  Clinical research in cardiology : official journal of the German Cardiac Society     Volume:  97     ISSN:  1861-0684     ISO Abbreviation:  -     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-20     Completed Date:  2008-10-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264123     Medline TA:  Clin Res Cardiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  288-97     Citation Subset:  IM    
Affiliation:
Klinik für Kardiologie, Westdeutsches Herzzentrum Essen, Zentrum für Innere Medizin, Universitätsklinikum Essen, Hufelandstrasse 55, 45122, Essen, Germany. stefan.sack@uk-essen.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Valve Stenosis / etiology,  mortality,  therapy*
Balloon Dilatation / methods*
Calcinosis / complications*,  mortality,  therapy
Cardiomyopathies / complications*,  mortality,  therapy
Female
Germany / epidemiology
Humans
Male
Middle Aged
Retrospective Studies
Risk Factors
Severity of Illness Index
Survival Rate
Treatment Outcome
Comments/Corrections
Comment In:
Clin Res Cardiol. 2008 May;97(5):285-7   [PMID:  18317665 ]

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