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[Valvuloplasty with balloon catheter in biologic prosthesis. Reality or illusion]
M Ledesma Velasco1, R Verdín Vázquez, J L Acosta Valdez
1Hospital General del Centro Médico La Raza, Instituto Mexicano del Seguro Social, México, D.F.
Archivos Del Instituto De Cardiologia De Mexico
|January 1, 1989
Summary
Catheter balloon valvuloplasty (CBV) can split fused bioprosthetic valves but may cause leaflet damage, emboli, and regurgitation. These risks suggest limited utility for CBV in treating stenotic bioprosthetic valves.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Biomaterials Science
Context:
- Bioprosthetic valves are used to replace diseased native heart valves.
- Degenerative changes, including calcification and fibrosis, can lead to stenosis in bioprosthetic valves.
- Catheter balloon valvuloplasty (CBV) is a minimally invasive procedure used to treat native valve stenosis.
Purpose:
- To investigate the pathological effects of catheter balloon valvuloplasty (CBV) on stenotic, operatively-excised bioprosthetic heart valves.
- To evaluate the potential complications and mechanisms of damage during CBV of bioprosthetic valves.
Summary:
- Eight stenotic bioprosthetic valves (Hancock and Ionescu Shiley) underwent pathological examination before and after CBV.
- Pre-CBV pathology revealed calcific deposits, fibrotic leaflets, and thickening.
- CBV resulted in commissural splitting, leaflet fractures, debris dislodgement, and one instance of acute regurgitation.
Impact:
- CBV can fracture calcific deposits, potentially causing emboli.
- Leaflet disruption during CBV can lead to acute insufficiency.
- The findings indicate a limited role for CBV in managing stenotic bioprosthetic valves in mitral and aortic positions.