Outcomes of concomitant percutaneous coronary intervention and balloon aortic valvuloplasty.

MedStar author(s):
Citation: Catheterization & Cardiovascular Interventions. 82(7):E835-41, 2013 Dec 1.PMID: 21735514Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Aortic Valve Stenosis/th [Therapy] | *Balloon Valvuloplasty | *Coronary Artery Disease/th [Therapy] | *Percutaneous Coronary Intervention | Aged | Aged, 80 and over | Aortic Valve Stenosis/co [Complications] | Aortic Valve Stenosis/di [Diagnosis] | Aortic Valve Stenosis/mo [Mortality] | Aortic Valve Stenosis/pp [Physiopathology] | Balloon Valvuloplasty/ae [Adverse Effects] | Balloon Valvuloplasty/mo [Mortality] | Contrast Media/du [Diagnostic Use] | Coronary Artery Disease/co [Complications] | Coronary Artery Disease/di [Diagnosis] | Coronary Artery Disease/mo [Mortality] | Coronary Artery Disease/pp [Physiopathology] | Feasibility Studies | Female | Hemodynamics | Humans | Kaplan-Meier Estimate | Male | Percutaneous Coronary Intervention/ae [Adverse Effects] | Percutaneous Coronary Intervention/mo [Mortality] | Retrospective Studies | Risk Factors | Severity of Illness Index | Time Factors | Treatment OutcomeYear: 2013Local holdings: Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006ISSN:
  • 1522-1946
Name of journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & InterventionsAbstract: AIM: To compare outcomes and complications of combined BAV and PCI with BAV alone.BACKGROUND: Coronary artery disease often coexists with severe aortic stenosis. The feasibility and safety of combined balloon aortic valvuloplasty (BAV) and percutaneous coronary intervention (PCI) are unknown.CONCLUSION: Combined BAV and PCI are safe and are associated with similar complications as BAV alone and may offer protection against myocardial ischemia during BAV. Copyright 2011 Wiley Periodicals, Inc.METHODS: The study cohort consisted of 409 patients with severe aortic stenosis undergoing BAV from 1/2007 to 12/2010. Overall, 329 patients underwent BAV alone and 80 underwent concomitant PCI. Clinical and hemodynamic data, as well as acute and intermediate-term outcomes, were collected.RESULTS: At the operator's discretion PCI was done before BAV in 66 (82.5%) and after in 14 (17.5%). Patients who underwent concomitant procedures had a higher incidence of prior stroke and a lower incidence of atrial fibrillation. Procedure time and fluoroscopic time were significantly greater in the BAV/PCI group, (90.0 + 36.6 vs. 72.8 + 39.8, P = 0.002 and 20.5 + 10.9 vs. 12.9 + 7.0, P < 0.001). Significantly more radiographic contrast was used in the BAV/PCI group (95.1 + 45.5 vs. 36.7 + 38.4 cm(3) , P < 0.001. Serious adverse events occurred with equal frequency 13.7 and 17.3%, P = 0.44). Transfusion requirement was also similar (21.2% vs. 20.0%, P = 0.81). The frequency of a periprocedural increase in troponin or creatinine was also similar. In the BAV alone group the mortality rate was 48.6% (n = 160) during a mean follow-up of 191 days, and in the BAV/PCI group the mortality rate was 40% (n = 32) during mean follow-up of 175.5 day, P = 0.34.All authors: Ben-Dor I, Lindsay J, Looser PM, Maluenda G, Okubagzi P, Pichard AD, Satler LF, Torguson R, Waksman R, Xue ZFiscal year: FY2014Digital Object Identifier: Date added to catalog: 2014-08-21
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 21735514 Available 21735514

Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006

AIM: To compare outcomes and complications of combined BAV and PCI with BAV alone.

BACKGROUND: Coronary artery disease often coexists with severe aortic stenosis. The feasibility and safety of combined balloon aortic valvuloplasty (BAV) and percutaneous coronary intervention (PCI) are unknown.

CONCLUSION: Combined BAV and PCI are safe and are associated with similar complications as BAV alone and may offer protection against myocardial ischemia during BAV. Copyright 2011 Wiley Periodicals, Inc.

METHODS: The study cohort consisted of 409 patients with severe aortic stenosis undergoing BAV from 1/2007 to 12/2010. Overall, 329 patients underwent BAV alone and 80 underwent concomitant PCI. Clinical and hemodynamic data, as well as acute and intermediate-term outcomes, were collected.

RESULTS: At the operator's discretion PCI was done before BAV in 66 (82.5%) and after in 14 (17.5%). Patients who underwent concomitant procedures had a higher incidence of prior stroke and a lower incidence of atrial fibrillation. Procedure time and fluoroscopic time were significantly greater in the BAV/PCI group, (90.0 + 36.6 vs. 72.8 + 39.8, P = 0.002 and 20.5 + 10.9 vs. 12.9 + 7.0, P < 0.001). Significantly more radiographic contrast was used in the BAV/PCI group (95.1 + 45.5 vs. 36.7 + 38.4 cm(3) , P < 0.001. Serious adverse events occurred with equal frequency 13.7 and 17.3%, P = 0.44). Transfusion requirement was also similar (21.2% vs. 20.0%, P = 0.81). The frequency of a periprocedural increase in troponin or creatinine was also similar. In the BAV alone group the mortality rate was 48.6% (n = 160) during a mean follow-up of 191 days, and in the BAV/PCI group the mortality rate was 40% (n = 32) during mean follow-up of 175.5 day, P = 0.34.

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