Balloon aortic valvuloplasty for severe aortic stenosis as a bridge to transcatheter/surgical aortic valve replacement.

MedStar author(s):
Citation: Catheterization & Cardiovascular Interventions. 82(4):632-7, 2013 Oct 1.PMID: 23015369Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal ArticleSubject headings: *Aortic Valve Stenosis/th [Therapy] | *Balloon Valvuloplasty | *Cardiac Catheterization | *Heart Valve Prosthesis Implantation/mt [Methods] | Aged | Aged, 80 and over | Aortic Valve Stenosis/di [Diagnosis] | Aortic Valve Stenosis/mo [Mortality] | Aortic Valve Stenosis/pp [Physiopathology] | Aortic Valve Stenosis/su [Surgery] | Balloon Valvuloplasty/ae [Adverse Effects] | Balloon Valvuloplasty/mo [Mortality] | Cardiac Catheterization/ct [Contraindications] | Female | Heart Valve Prosthesis Implantation/ct [Contraindications] | Hemodynamics | Humans | Male | Patient Selection | 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: BACKGROUND: The introduction of transcatheter aortic valve replacement (TAVR) has led to a revival in BAV as treatment for patients with severe aortic stenosis.CONCLUSION: In high-risk patients with aortic stenosis and temporary contraindications to SAVR/TAVR, BAV may be used as a bridge to intervention with good mid-term outcomes. Copyright 2012 Wiley Periodicals, Inc.METHODS: A cohort of 472 patients underwent 538 BAV procedures. The cohort was divided into two groups: BAV alone 387 (81.9%) and BAV as a bridge 85 (18.1%) to (n = 65, TAVR; n = 20, surgery). Clinical, hemodynamic, and follow-up mortality data were collected.OBJECTIVES: This study aimed to determine success- and complication rates after balloon aortic valvuloplasty (BAV) and the outcome of BAV as a standalone therapy versus BAV as a bridge to transcatheter/surgical aortic valve replacement (T/SAVR).RESULTS: There was no significant difference between the two groups in mean age (81.7 + 8.3 vs. 83.2 + 10.9 years, P = 0.18), society of thoracic surgeons score (13.1 + 6.2 and 12.4 + 6.4, P = 0.4), logistic EuroSCORE (45.4 + 22.3 vs. 46.9 + 21.8, P = 0.43), and other comorbidities. The mean increase in aortic valve area was 0.39 + 0.25 in the BAV alone group and 0.42 + 0.26 in the BAV as a bridge group, P = 0.33. The decrease in mean gradient was 24.1 + 13.1 in the BAV alone group vs. 27.1 + 13.8 in the BAV as a bridge group, P = 0.06. During a median follow up of 183 days [54-409], the mortality rate was 55.2% (n = 214) in the BAV alone group vs. 22.3% (n = 19) in the BAV as a bridge group during a median follow-up of 378 days [177-690], P < 0.001.All authors: Barbash IM, Ben-Dor I, Dvir D, Lindsay J, Maluenda G, Okubagzi P, Pichard AD, Satler LF, Torguson R, Waksman RFiscal 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 23015369 Available 23015369

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

BACKGROUND: The introduction of transcatheter aortic valve replacement (TAVR) has led to a revival in BAV as treatment for patients with severe aortic stenosis.

CONCLUSION: In high-risk patients with aortic stenosis and temporary contraindications to SAVR/TAVR, BAV may be used as a bridge to intervention with good mid-term outcomes. Copyright 2012 Wiley Periodicals, Inc.

METHODS: A cohort of 472 patients underwent 538 BAV procedures. The cohort was divided into two groups: BAV alone 387 (81.9%) and BAV as a bridge 85 (18.1%) to (n = 65, TAVR; n = 20, surgery). Clinical, hemodynamic, and follow-up mortality data were collected.

OBJECTIVES: This study aimed to determine success- and complication rates after balloon aortic valvuloplasty (BAV) and the outcome of BAV as a standalone therapy versus BAV as a bridge to transcatheter/surgical aortic valve replacement (T/SAVR).

RESULTS: There was no significant difference between the two groups in mean age (81.7 + 8.3 vs. 83.2 + 10.9 years, P = 0.18), society of thoracic surgeons score (13.1 + 6.2 and 12.4 + 6.4, P = 0.4), logistic EuroSCORE (45.4 + 22.3 vs. 46.9 + 21.8, P = 0.43), and other comorbidities. The mean increase in aortic valve area was 0.39 + 0.25 in the BAV alone group and 0.42 + 0.26 in the BAV as a bridge group, P = 0.33. The decrease in mean gradient was 24.1 + 13.1 in the BAV alone group vs. 27.1 + 13.8 in the BAV as a bridge group, P = 0.06. During a median follow up of 183 days [54-409], the mortality rate was 55.2% (n = 214) in the BAV alone group vs. 22.3% (n = 19) in the BAV as a bridge group during a median follow-up of 378 days [177-690], P < 0.001.

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