[Percutaneous angioplasty of the stenotic aortic valve: results, hemodynamic effects and complications]

In 24 patients with aortic stenosis (13 men and 11 women, aged 47 to 80 years; mean age 67 years) a percutaneous angioplasty of the aortic valve was performed. The NYHA functional class improved in 20 patients. There was also a significant (p less than 0.01) decrease of the mean aortic gradient from 75.1 +/- 21.8 mm Hg to 45.3 +/- 11.7 mm Hg as well as an increase of the aortic valve area from 0.61 +/- 0.12 cm2 to 0.96 +/- 0.3 cm2. The end diastolic volume index decreased from 121.3 +/- 37.4 ml/m2 to 99.6 +/- 24.8 ml/m2 to the end diastolic volume index from 49.1 +/- 26.6 ml/m2 to 34.6 +/- 13.4 ml/m2 (both significant: p less than 0.01). The ejection fraction increased from 61.3 +/- 11.8% to 65.8 +/- 7.8% (p less than 0.05). Four patients presented a transient left bundle branch block. The corrected QT interval increased significantly (p less than 0.01) from 388.9 +/- 29 ms to 401.4 +/- 42.6 ms. Complications occurred in eight patients, being severe in three of them (one death from intractable internal hemorrhage, two cases of right sided hemiparesis).

Percutaneous aortic valve angioplasty represents an alternative to the surgical procedure. In our patients there was not only an increase in the aortic valve area, but also an improvement in the ejection fraction. Nevertheless, unforeseeable complications may occur which obscure the results. In the future, widened experience and improved technique will reduce complications.