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[Percutaneous aortic valvuloplasty in the elderly. Evaluation in 1990]
1Service de cardiologie, hôpital universitaire Saint-Jacques, Besançon, France.
La Revue Du Praticien
|November 11, 1990
Summary
Percutaneous aortic valvuloplasty offers temporary relief for aortic stenosis but often leads to restenosis. Long-term benefits are limited, making it suitable only for elderly patients with contraindications to surgery.
Area of Science:
- Cardiology
- Interventional Cardiology
- Valvular Heart Disease
Context:
- Aortic stenosis (AS) is a common valvular heart disease, particularly in the elderly.
- Percutaneous aortic valvuloplasty (PAV) was developed to treat AS, initially as a palliative measure.
- The procedure involves mechanically opening the narrowed aortic valve.
Purpose:
- To assess the efficacy and long-term outcomes of percutaneous aortic valvuloplasty for aortic stenosis.
- To evaluate the potential of PAV in improving symptoms and valve function.
- To determine the durability of results and the need for subsequent interventions.
Summary:
- PAV provides modest, temporary improvement in aortic valve area and reduces transvalvular gradients.
- Complications and mortality rates range from 3-8%.
- Restenosis occurs frequently, with about 50% incidence at 9 months, leading to symptom recurrence and often requiring valve replacement.
Impact:
- PAV is generally reserved for elderly patients with severe aortic stenosis for whom surgical risk is prohibitive.
- The procedure's limited long-term efficacy restricts its use in younger patients or as a definitive treatment.
- Further research may explore modifications or adjuncts to improve PAV durability.