Early clinical outcomes of percutaneous balloon aortic valvuloplasty in treating high-risk patients with severe aortic stenosis.

Hanjun Pei; Yongjian WU; Yuejin Yang; Siyong Teng; Haitao Zhang; Lei Zhang; Hongxia Niu; Wenjia Zhang; Guannan Niu; Jie Qian; Shubin Qiao; Bo XU; Runlin Gao

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Early clinical outcomes of percutaneous balloon aortic valvuloplasty in treating high-risk patients with severe aortic stenosis.

Author: Hanjun PEI ¹ ; Yongjian WU ² ; Yuejin YANG ; Siyong TENG ; Haitao ZHANG ; Lei ZHANG ; Hongxia NIU ; Wenjia ZHANG ; Guannan NIU ; Jie QIAN ; Shubin QIAO ; Bo XU ; Runlin GAO
Author Information

1. Coronary Heart Disease Center, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
2. Email: fuwaihospital@gmail.com.
Publication Type:Journal Article
MeSH: Aorta; Aortic Valve; Aortic Valve Insufficiency; Aortic Valve Stenosis; therapy; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Percutaneous Coronary Intervention; Retrospective Studies; Risk Factors; Treatment Outcome
From: Chinese Journal of Cardiology 2015;43(1):34-38
CountryChina
Language:Chinese
Abstract:
OBJECTIVETo explore the procedural feasibility and early clinical outcomes of percutaneous balloon aortic valvuloplasty (PBAV) in patients with severe aortic stenosis, who were considered transiently unsuitable for surgical aortic valve replacement (sAVR) and transcatheter aortic valve replacement (TAVR).
METHODSBetween March 2011 and January 2014, datas of 20 patients underwent PBAV in Fuwai Hospital were retrospectively analyzed. Mean patients age was (72 ± 8) years.Initial procedural and clinical outcomes were evaluated.
RESULTSPBAV was successfully performed in all cases. Post-procedure, aortic valve area increased from (0.55 ± 0.09) m(2) to (0.77 ± 0.15) m(2)(P < 0.001), left ventricle ejection fraction from (31.7 ± 9.0) % to (39.0 ± 11.0) % (P = 0.018), mean transaortic valve gradient decreased from (49.5 ± 15.0) mmHg (1 mmHg = 0.133 kPa) to (31.7 ± 12.0) mmHg (P < 0.001), and pulmonary artery systolic pressure decreased from (55.1 ± 18.0) mmHg to (38.7 ± 11.0) mmHg (P = 0.025) . There was no significant change in the aortic regurgitation grade (P = 0.854). The most common complications were hypotension (n = 4) and transient left bundle branch block (n = 5). Overall 24-hour and 30-day mortality was 5% (n = 1) and 15% (n = 3), respectively. Within 30 days after PBAV procedure, five patients underwent successful sAVR, one patient underwent TAVR, and five patients awaited TAVR.
CONCLUSIONIn high-risk patients with severe aortic stenosis and temporary contraindication to sAVR or TAVR, PBAV can be safely used as a bridging intervention procedure and the short-term procedural and clinic outcomes are satisfactory.