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Percutaneous balloon aortic valvuloplasty for aortic stenosis in elderly patients at high risk for surgery

J F Schneider, M Wilson, T E Gallant

    Annals of Internal Medicine
    |May 1, 1987
    PubMed

    Insights

    Percutaneous balloon aortic valvuloplasty safely improved aortic valve area and relieved symptoms in high-risk elderly patients with severe calcific aortic stenosis. This minimally invasive procedure offers a viable alternative to surgery for select patients.

    Area of Science:

    • Cardiology
    • Interventional Cardiology
    • Geriatric Medicine

    Background:

    • Severe calcific aortic stenosis poses significant risks for elderly patients.
    • Surgical valve replacement may be contraindicated due to comorbidities or patient refusal.
    • Limited treatment options exist for high-risk patients with symptomatic aortic stenosis.

    Purpose of the Study:

    • To evaluate the safety and efficacy of percutaneous balloon aortic valvuloplasty (PBAV) in elderly patients with severe calcific aortic stenosis.
    • To assess the procedural outcomes, including hemodynamic changes and symptom improvement.
    • To determine the feasibility of PBAV as an alternative to surgery in high-risk individuals.

    Main Methods:

    • Six elderly patients with severe, symptomatic calcific aortic stenosis underwent PBAV.
    • Patients were selected due to high surgical risk or refusal of surgery.
    • Hemodynamic parameters (aortic valve gradient, valve area) and clinical outcomes were assessed.

    Main Results:

    • PBAV significantly reduced the mean aortic valve gradient by 32% (p < 0.01).
    • The mean aortic valve area significantly increased by 40% (p < 0.001).
    • All patients were alive at 2-month follow-up, with significant improvement in dyspnea (1-2 NYHA classes).
    • Femoral artery bleeding was the only major complication.

    Conclusions:

    • PBAV is a safe and effective procedure for improving aortic valve area and alleviating symptoms in elderly patients with severe calcific aortic stenosis at high surgical risk.
    • The procedure offers a significant short-term benefit and can be performed with minimal complications.
    • PBAV represents a valuable therapeutic option for carefully selected high-risk patients.

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