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Results of percutaneous valvuloplasty for calcific aortic stenosis with different balloon catheters
V Voudris1, G Drobinski, Y L'Epine
1Service de Cardiologie, C.H.U. Pitié-Salpérière, Paris, France.
Insights
Percutaneous aortic valvuloplasty offers palliative care for severe aortic stenosis. The bifoil balloon catheter demonstrated superior results and better procedural tolerance compared to monofoil and trefoil balloons in a patient series.
Area of Science:
- Cardiology
- Interventional Cardiology
- Valvular Heart Disease
Background:
- Calcific aortic stenosis poses a significant risk for patients unsuitable for surgery.
- Percutaneous aortic valvuloplasty serves as a palliative treatment option.
Purpose of the Study:
- To analyze the outcomes and complications of percutaneous aortic valvuloplasty.
- To compare the efficacy of different balloon catheter types in this procedure.
Main Methods:
- A retrospective analysis of 47 patients undergoing percutaneous aortic valvuloplasty.
- Patients were divided into three groups based on balloon catheter type: single (monofoil), bifoil, and trefoil.
Main Results:
- All patients experienced an increase in aortic valve area.
- The bifoil balloon group showed significantly greater improvement in aortic area (+118%) compared to monofoil (+74%) and trefoil (+76%) (P < 0.05).
- The bifoil balloon also allowed for shorter inflation/deflation times, indicating better procedural tolerance.
Conclusions:
- Balloon aortic valvuloplasty is an effective palliative treatment for selected patients with aortic stenosis.
- The bifoil balloon dilating catheter is recommended for optimal outcomes and procedural efficiency.
- The procedure is associated with generally low complication rates when indicated.
Abstract:
Percutaneous aortic valvuloplasty is a palliative treatment for patients with calcific aortic stenosis who would be poor candidates for surgical treatment. The results and associated complications of this procedure were analysed in a series of 47 patients in which different types of dilating catheters were used. In 25 patients a single balloon (19 mm) was used (group A), in 13 patients a bifoil balloon (2 x 15mm) (group B), and in the remaining nine patients (group C) a trefoil balloon (3 x 10mm) was used. An increase in aortic valve area was achieved in all patients. The results obtained with the bifoil balloon were better than with the other types of balloon catheter, with an increase in aortic area of + 118% vs. + 74% (monofoil) and + 76% (trefoil) (P less than 0.05). The tolerance of the inflation procedure was also better with this type of balloon, as it allowed for shorter inflation and deflation times. These results show that balloon aortic valvuloplasty, when indicated, is best performed with a bifoil balloon dilating catheter, and undue complications usually do not occur.