Acute and long-term outcomes of percutaneous balloon aortic valvuloplasty for the treatment of severe aortic stenosis

作者：Daniec Marzena; Nawrotek Bartlomiej; Sorysz Danuta; Rakowski Tomasz; Dziewierz Artur; Rzeszutko Lukasz; Kleczynski Pawel; Trebacz Jaroslaw; Tomala Marek; Zmudka Krzysztof; Dudek Dariusz^*

来源：Catheterization and Cardiovascular Interventions, 2017, 90(2): 303-310.

DOI：10.1002/ccd.26697

• balloon aortic valvuloplasty
• aortic stenosis
• transcatheter aortic valve implantation
• surgical aortic valve replacement

ObjectivesThis study aimed to evaluate the indications, short- and long-term outcomes of balloon aortic valvuloplasty (BAV) in patients with severe aortic stenosis (AS).
MethodsA cohort of 112 patients with AS underwent 114 BAV procedures between October 2012 and July 2015 in two Polish interventional cardiology centers. Clinical and echocardiographic data were prospectively collected within 1, 6, and 12 months follow-up.
ResultsBAV was performed as a bridge to TAVI (51.8%), surgical aortic valve replacement (AVR, 5.4%), before urgent noncardiac surgery (8.0%), for symptom relief (33.0%) and cardiogenic shock (1.8%). Periprocedural, in-hospital, 1-, 6-, 12-month mortality were 2.7%; 8.9%; 8.9%; 16.9%; 22.3%, respectively. Serious periprocedural adverse events occurred in 18.8% of patients. After the procedure, mean aortic valve area (AVA) increased from 0.590.18 to 0.82 +/- 0.24 cm(2), mean peak aortic valve gradient (pAVG) decreased from 94.0 +/- 27.6 to 65.4 +/- 20.0 mm Hg, mean aortic gradient decreased from 58.0 +/- 17.8 to 40.5 +/- 14.6 mm Hg, P<0.05 for all. Left ventricular ejection fraction (LVEF) increased from median (interquartile range) of 53.5 (30-64) to 60 (45-65)% after 1 month (P<0.05). In patients with impaired left ventricle LVEF <40%), LVEF significantly improved (median increase of 16%) after 1 and 6 months (P<0.05). At 12 months patients had higher AVA, pAVG, and LVEF as compared to baseline (P<0.05).
ConclusionsBAV is a useful procedure in high-risk AS patients, where achieved effects can be sufficient in bridging patients for TAVI/AVR.

• 出版日期2017-8-1