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Patients with small left ventricular size undergoing balloon aortic valvuloplasty have worse intraprocedural outcomes

Creighton Don1, Pritha P Gupta, Christian Witzke

  • 1Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. cwdon@u.washington.edu

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|August 29, 2012
PubMed

Insights

Patients with smaller left ventricular (LV) chambers undergoing balloon aortic valvuloplasty (BAV) face higher risks of procedural and in-hospital complications. This highlights the importance of LV size in BAV outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Balloon aortic valvuloplasty (BAV) is a critical component of transcatheter aortic valve implantation.
  • Concerns exist regarding increased complications in patients with small, thickened ventricles during and after BAV.

Purpose of the Study:

  • To investigate the association between left ventricular (LV) chamber size and outcomes following aortic valvuloplasty.
  • To determine if smaller LV end-diastolic diameters (LVEDD) predict adverse procedural or hospital events.

Main Methods:

  • Retrospective analysis of patients with severe, symptomatic calcific aortic stenosis undergoing retrograde BAV.
  • Comparison of outcomes between patients with LVEDD < 4.0 cm and LVEDD ≥ 4.0 cm.
  • Multivariate logistic regression to identify independent predictors of complications.

Main Results:

  • Patients with smaller LV chambers (LVEDD < 4.0 cm) were predominantly female and had smaller body surface area.
  • A significantly higher rate of intraprocedural complications (death, arrest, collapse, tamponade) was observed in the smaller LV group (32.3% vs. 11.5%).
  • Smaller LVEDD (< 4.0 cm) was an independent predictor of both procedural (OR 5.1) and in-hospital complications (OR 3.8).

Conclusions:

  • Patients with smaller LV chambers undergoing BAV experience significantly worse procedural and in-hospital outcomes.
  • LV chamber size is a crucial factor influencing the safety and efficacy of BAV procedures.
Abstract

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