[Aortic valvuloplasty in the elderly. Immediate and medium-term results]

Between January 86 and February 88 we attempted percutaneous aortic valvuloplasty in 100 patients. 68 patients could be dilated with hemodynamic success: the aortic valve area increased from 0.52 +/- 0.17 cm2 to 0.78 +/- 0.27 cm2 (p less than 0.001). Cardiac output did not change significantly (4 +/- 1.1 l/mn). In the remaining 32 patients: 8 patients (8%) died in hospital and the morbidity rate was 11%: arterial injury (9), stroke (1) and major cardiac event (1). Sixty patients regarded as initial success were followed for 6 months: 3 patients (5%) died without cardiac events, functional improvement persisted in 41 patients (68%) and clinical failure was observed in 16 patients (27%): 4 patients died and in the remaining 12 patients, the recurrence of symptoms required medical treatment (5), surgery (5) or repeat percutaneous valvuloplasty (2). Echo-Doppler maximum aortic valve gradient was significantly less in improved patients (55 +/- 21 mmHg) than in deteriorated patients (78 +/- 36 mmHg) (p less than 0.02). One year after valvuloplasty: actuarial survival was 74 +/- 6%, clinical improvement was 53 +/- 7% and clinical recurrence was 41 +/- 7%. Thus percutaneous aortic valvuloplasty may be proposed only to non surgical patients.