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Balloon valvoplasty in calcific aortic stenosis: a therapeutic alternative
J R Büchler1, S L Braga, S F Assis
1Institute Dante Pazzanese of Cardiology, São Paulo, Brazil.
Insights
Percutaneous balloon valvoplasty effectively reduced systolic gradients in three women with calcific aortic stenosis. The procedure demonstrated a favorable safety profile with minimal complications.
Area of Science:
- Cardiology
- Interventional Cardiology
- Valvular Heart Disease
Background:
- Calcific aortic stenosis (CAS) is a progressive condition leading to significant hemodynamic compromise.
- Transcatheter interventions are increasingly explored for CAS management, particularly in elderly or high-risk patients.
Observation:
- Three female patients (aged 61-73 years) with symptomatic calcific aortic stenosis underwent percutaneous balloon valvoplasty.
- Vascular access was achieved via the left brachial artery in one patient and the right femoral artery in two patients.
Findings:
- An 18 mm balloon was utilized in all cases, resulting in a substantial reduction of systolic gradients from baseline (50, 180, 48 mm Hg) to post-procedure levels (7, 50, 35 mm Hg).
- One patient experienced mild, transient systemic embolization.
- Aortic regurgitation remained absent in two patients and showed a minor, non-progressive increase (grade 1/6 to 2/6) in one patient.
- A small, localized aortic dissection occurred in one case but resolved by day 11 follow-up angiography.
Implications:
- Percutaneous balloon valvoplasty is a viable treatment option for calcific aortic stenosis, offering significant hemodynamic improvement.
- The procedure appears to have an acceptable safety profile, with most complications being mild and transient.
- Further research may explore the long-term efficacy and optimal patient selection for balloon valvoplasty in calcific aortic stenosis.
Abstract:
Percutaneous balloon valvoplasty was used to treat calcific aortic stenosis in 3 women aged 73, 67 and 61 years, respectively. We approached through the left brachial artery in the first case and the right femoral artery in the other two. An 18 mm balloon was used in all cases, the systolic gradient being reduced from 50, 180 and 48 to 7, 50 and 35 mm Hg, respectively. A mild and transitory systemic embolization was observed in one case. Aortic regurgitation was not present in two patients either before or after valvoplasty. In the other case, a grade 1/6 murmur indicative of regurgitation prior to the procedure increased to a grade 2/6 afterwards. A small and localized aortic dissection was present in one case but disappeared in the control angiography performed 11 days later.