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Balloon aortic valvuloplasty in 170 consecutive patients
R D Safian1, A D Berman, D J Diver
1Cardiovascular Division, Beth Israel Hospital, Boston, MA 02215.
The New England Journal of Medicine
|July 21, 1988
Summary
Balloon aortic valvuloplasty effectively relieved symptoms in elderly patients with aortic stenosis. While restenosis occurred, repeat procedures offered management, with a 74% survival rate at 12 months.
Area of Science:
- Cardiology
- Interventional Cardiology
- Geriatric Medicine
Background:
- Symptomatic aortic stenosis poses a significant health risk, particularly in elderly populations.
- Traditional treatment options may carry high risks for older patients.
Purpose of the Study:
- To evaluate the efficacy and outcomes of balloon aortic valvuloplasty (BAV) in elderly patients with symptomatic aortic stenosis.
Main Methods:
- BAV was performed on 170 elderly patients (mean age 77 years) with symptomatic aortic stenosis.
- Hemodynamic parameters including aortic-valve area, cardiac output, and pressure gradient were assessed.
- Patient survival and symptom recurrence were monitored post-procedure.
Main Results:
- Successful BAV in 168 patients led to significant improvements in aortic-valve area and cardiac output, and reduced pressure gradients (P < 0.01).
- In-hospital mortality was 3.5% (6 patients), with 2.9% requiring early aortic-valve replacement.
- At 12 months, the estimated survival probability was 74%; symptom improvement was noted in 103 patients, with restenosis managed by repeat dilation in 15.
Conclusions:
- Balloon aortic valvuloplasty serves as an effective palliative treatment for select elderly patients with symptomatic aortic stenosis.
- Despite common restenosis, repeat balloon dilation can successfully manage recurrence in some cases.
- BAV offers symptomatic relief and improved hemodynamics, contributing to survival in this high-risk group.