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One-wire technique for performance of balloon aortic valvuloplasty
Sherri S Baker1, Martin P O'Laughlin
1Pediatric Cardiovascular Program, Duke University Medical Center, Durham, North Carolina, USA. sherri-baker@ouhsc.edu
Background:
We present a new one-wire technique for balloon aortic valvuloplasty and discuss possible advantages of this technique over other techniques.
Methods:
The records of 16 patients who underwent 18 procedures were reviewed.
Technique:
A floppy-tipped, nitinol wire (Ultra-Select, Microvena Corp., White Bear Lake, MN) is placed across the aortic valve through a guide/measurement catheter positioned in the aortic root. The guide catheter is then removed, and the balloon catheter is positioned. Balloon dilation is then performed.
Results:
Pre-dilation all patients had 0-1+ aortic insufficiency (AI). Four of 18 procedures resulted in an increase of >1 grade of AI, leaving 14 of 18 with < or =1 grade increase in AI. The mean gradient reduction achieved was 65%.
Follow-Up:
Eighty-seven percent of the procedures have required no further intervention.
Conclusion:
The ease and simplicity of the procedure may reduce the risk of increasing AI, decrease fluoroscopy time, and arterial access time.