Application for a Bridge Therapy of Percutaneous Balloon Aortic Valvuloplasty in the Era of Transcatheter Aortic Valve Replacement: A Single Center Experience
10.3969/j.issn.1000-3614.2018.04.006
- VernacularTitle:过渡性经皮球囊主动脉瓣成形术在治疗危重主动脉瓣狭窄患者的临床应用——单中心经验
- Author:
Mo-Yang WANG
1
;
Guang-Yuan SONG
;
Han-Jun PEI
;
Yuan WANG
;
Qian ZHANG
;
Guan-Nan NIU
;
Zheng ZHOU
;
Hao ZHANG
;
Wen-Jia ZHANG
;
Jian-De WANG
;
Bin LV
;
Yong-Jian WU
;
Shu-Bin QIAO
;
Yue-Jin YANG
;
Run-Lin GAO
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 冠心病诊治中心
- Keywords:
Aortic stenosis;
Percutaneous balloon aortic valvuloplasty;
Bridge therapy
- From:
Chinese Circulation Journal
2018;33(4):336-340
- CountryChina
- Language:Chinese
-
Abstract:
Objectives: To explore the clinical experience for a bridge therapy of percutaneous balloon aortic valvuloplasty (PBAV) in treating the patients with severe aortic stenosis (AS). Methods: A total of 37 patients with severe AS who were not suitable for surgical valvular replacement received PBAV in our hospital from 2011-03 to 2017-03 were retrospectively studied. The patient's mean age was (74±12) years, their clinical and anatomical features, efficacy and safety of operation were observed and the outcomes were evaluated by follow-up study. Results: Patients presented the high surgical risk and worse cardiac function, 50% of them had bicuspid leaflet morphology with severe calcification [HU850=(856.0±658.2) mm3]. Balloon size was chosen by the intra-operative supra-annular diameters; at 7 days after operation, aortic valve orifice area (AVOA) was increased from (0.37±0.10) cm2to (0.87±1.10) cm2, the mean trans-aortic valve gradient pressure decreased form (55.1±22.9) mmHg to (44.8±17.8) mmHg, P<0.001 and LVEF elevated form(35.8±14.3)% to(41.0±12.2)%,P<0.001.There were 4 patients died in hospital,1 received permanent pacemaker and 1 developed severe aortic valve regurgitation. The patients were followed-up for (16.5±11.1)months after operation, 13/37 (35.1%) patients were in transition to surgical or transcatheter aortic valve replacement (TAVR). Conclusions: PBAV may have good early clinical efficacy in severe AS patients who were not suitable for surgical valvular replacement and TAVR; PBAV could be expected to become a bridge therapy, smaller supra-annular diameter was safe and effective for patients having bicuspid leaflet with severe calcification.
