[Percutaneous aortic valvuloplasty: immediate results in calcified aortic stenosis]

Symptomatic calcific aortic stenosis in elderly patients has a poor prognosis and a relatively high surgical risk. Percutaneous aortic valvuloplasty is a new therapeutic procedure that may be applied in this group of patients. We report immediate results obtained with this technique in a cooperative study of 3 hospitals. In 16 of 19 patients we were able to locate a balloon catheter across the aortic valve following a femoral artery puncture. Mean age was 72 years and almost all patients were considered high surgical risk. Peak aortic gradient fell from 89 + 33 to 47 + 21 mmHg while valve area rose from 0.43 + 0.14 to 0.66 + 0.27 cm2; cardiac output remained unchanged. In 5 patients, an aortic valve area above 0.7 cm2 was obtained. Four patients needed blood transfusion, one developed pericardial tamponade and other recovered uneventfully from ventricular fibrillation. One patient died hours after the procedure in a low output state probably related to aortic insufficiency. We feel that aortic valvuloplasty is indicated in patients with severe calcific aortic stenosis and high surgical risk. Moderate improvement can be obtained with risks commensurate with the severity of the illness.