Clinical Application of Percutaneous Balloon Aortic Valvuloplasty in Patients With Calcified Severe Aortic Stenosis Combining Heart Failure
10.3969/j.issn.1000-3614.2018.02.011
- VernacularTitle:经皮主动脉瓣球囊扩张术在钙化型重度主动脉瓣狭窄合并左心功能不全患者中的临床应用
- Author:
Bin WANG
1
;
Mao-Long SU
;
Feng QIU
;
Ke-Ke LAI
;
Hong-Mei WEN
;
Jian WANG
;
Yan WANG
Author Information
1. 厦门大学附属心血管病医院 心内科
- Keywords:
Aortic stenosis;
Heart valves valvuloplasty;
Heart failure
- From:
Chinese Circulation Journal
2018;33(2):152-156
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To assess the clinical application of percutaneous balloon aortic valvuloplasty (PBAV) in patients with calcified severe aortic stenosis (AS) combining heart failure (HF). Methods: A total of 15 relevant patients treated by PBAV in our hospital from 2014-12 to 2017-05 were studied. The baseline information, echocardiography parameters, peri-operative situation and follow-up condition were summarized. Results: All 15 AS patients were combined with severe HF including 3 with NYHA III and 12 with NYHA IV; 2 cases had cardiac shock. 6/15 patients received palliative PBAV for symptom relieving and 9 for bridging step (1 case pre-operative step for non-cardiogenic surgery). PBAV was successful in all patients; the average operative dilation was (2.60±1.3) times; 2 patients suffered from complete left bundle block at immediate post-operation, 1 had ventricular tachycardia during the operation and 1 had ischemic stroke 3 days after operation, no other complications occurred. Catheter measured immediate post-operative peak trans-valvular pressure gradient was decreased from (75.0±24.0) mmHg to (39.8±14.2) mmHg, P<0.01. Echocardiography showed that before discharge, the max flow velocity was reduced from (4.98±0.76) m/s to (4.20±0.75) m/s, P<0.01, max-PG reduced from(101.3±30.4) mmHg to (72.9.0±23.3) mmHg, P<0.01, mean-PG reduced from (62.4±19.0) mmHg to (44.9±15.1) mmHg, P<0.01;while left ventricular diastolic dimension and LVEF were similar at per- and post-operation, P>0.05. NT-proBNP was decreased from (13 889±12 303) pg/ml to (5 412±4 923) pg/ml, P<0.01. The average post-operative follow-up time was (3-27) months and the median NYHA grade improved from IV to II. Conclusion: Palliative and bridging PBAV was reliable and safe in severe AS-HF patients for short time, it had less complication and could be used as an optional treatment.
