Document Detail


Standalone balloon aortic valvuloplasty: indications and outcomes from the UK in the transcatheter valve era.
MedLine Citation:
PMID:  22730270     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to characterize UK-wide balloon aortic valvuloplasty (BAV) experience in the TAVI era.
BACKGROUND: BAV for acquired calcific aortic stenosis is in a phase of renaissance, largely due to the development of transcatheter aortic valve implantation (TAVI).
METHODS: Data from 423 patients at 14 centers across the UK were analyzed.
RESULTS: Patients were aged 80.9 ± 9.5 years; 52.5% were male. Mean logistic EuroScore was 27.3% ± 16.8%. Mean peak transaortic gradient fell from 62.0 ± 26.3 to 28.3 ± 16.2 mm Hg. Aortic valve area increased from 0.58 ± 0.19 to 0.80 ± 0.25 cm(2) echocardiographically. Procedural complication rate was 6.3%, comprising death (2.4%), blood transfusion ≥ 2 U (1.2%), cardiac tamponade (1.0%), stroke (1.0%), vascular surgical repair (1.0%), coronary embolism (0.5%), and permanent pacemaker (0.2%). Mortality was 13.8% at 30 days and 36.3% at 12 months. Subsequently, 18.3% of patients underwent TAVI and 7.0% sAVR, with improved survival compared to those who had no further intervention (logrank < 0.0001). Multivariate Cox proportional hazard analysis demonstrated that survival was adversely effected by the presence of coronary artery disease (HR 1.53, 95%CI 1.08-2.17, P = 0.018), poor LV function (HR 1.54, 95%CI 1.09-2.16, P = 0.014), and either urgent (HR 1.70, 95%CI 1.18-2.45; P = 0.004) or emergent presentation (HR 3.72, 95%CI 2.27-6.08; P < 0.0001).
CONCLUSION: Balloon aortic valvuloplasty offers good immediate hemodynamic efficacy at an acceptable risk of major complications. Medium-term prognosis is poor in the absence of definitive therapy.
Authors:
Muhammed Z Khawaja; Manav Sohal; Haseeb Valli; Rafal Dworakowski; Stephen J Pettit; David Roy; James Newton; Heiko Schneider; Ganesh Manoharan; Sagar Doshi; Douglas Muir; David Roberts; James Nolan; Mark Gunning; Cameron Densem; Mark S Spence; Saqib Chowdhary; Vaikom S Mahadevan; Stephen J Brecker; Philip Maccarthy; Michael Mullen; Rodney H Stables; Bernard D Prendergast; Adam de Belder; Martyn Thomas; Simon Redwood; David Hildick-Smith
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  81     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-20     Completed Date:  2013-08-12     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  366-73     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Wiley Periodicals, Inc.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Valve / pathology,  physiopathology
Aortic Valve Stenosis / diagnosis,  mortality,  physiopathology,  therapy*
Balloon Valvuloplasty* / adverse effects,  mortality
Calcinosis / diagnosis,  mortality,  physiopathology,  therapy*
Cardiac Catheterization* / adverse effects,  mortality
Chi-Square Distribution
Female
Great Britain
Heart Valve Prosthesis Implantation / adverse effects,  methods*,  mortality
Hemodynamics
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Risk Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
FS/12/15/29380//British Heart Foundation
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2013 Feb;81(2):374-5   [PMID:  23423930 ]

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


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