Balloon aortic valvuloplasty in the era of transcatheter aortic valve replacement: Acute and long-term outcomes - 20/01/14
, Eric Durand, MD, PhD a, c, Bogdan Borz, MD a, Akira Furuta, MD a, Karim Bejar, MD a, Alexandre Canville, MD a, Ali Farhat, MD a, Chiara Fraccaro, MD a, Matthieu Godin, MD a, Christophe Tron, MD a, Rahul Sakhuja, MD b, Alain Cribier, MD aRésumé |
Background |
The use of balloon aortic valvuloplasty (BAV) has resurged since the development of transcatheter aortic valve replacement (TAVR). The aim of our study was to determine the procedural and long-term outcomes of patients treated by BAV in the early TAVR era.
Methods |
From 2005 to 2008, 323 consecutive patients presenting with severe aortic stenosis were treated by BAV in our institution.
Results |
Mean age and logistic EuroSCORE were 80.5 ± 9.9 years and 28.7% ± 12.5%, respectively. The effective orifice area increased from 0.68 ± 0.25 to 1.12 ± 0.39 cm2 (P < .001) after BAV. Inhospital major complications occurred in 22 patients (6.8%), with a mortality rate of 2.5%. Eighty-five patients (26.3%) were bridged to surgical aortic valve replacement (SAVR, 9.6%) or TAVR (16.7%). Twenty-eight patients (8.7%) had at least 1 repeat BAV. Two hundred ten patients (65%) received only medical therapy post-BAV. Mean duration of follow-up was 20.7 ± 20.0 months. Kaplan-Meier analysis demonstrated that survival after single BAV was poor. Patients treated by BAV followed by SAVR or TAVR had the highest long-term survival rate (P < .001). Multivariable analysis revealed that logistic EuroSCORE, severe aortic regurgitation and stroke complications post-BAV, and medical therapy post-BAV were independent predictors of mortality.
Conclusions |
The results of our study suggest that BAV is an acceptable bridge to SAVR or TAVR in a very high-risk population not immediately suitable for definitive therapy. Balloon aortic valvuloplasty remains only a brief temporizing procedure with a poor long-term outcome without subsequent definitive therapy.
Le texte complet de cet article est disponible en PDF.Plan
Vol 167 - N° 2
P. 235-240 - février 2014 Retour au numéro
Article précédent
- Short-term hemodynamic effect of angiotensin-converting enzyme inhibition in patients with severe aortic stenosis : A placebo-controlled, randomized study
- Morten Dalsgaard, Kasper Iversen, Jesper Kjaergaard, Peer Grande, Jens Peter Goetze, Peter Clemmensen, Christian Hassager
- Multicenter randomized trial of 3-month cilostazol use in addition to dual antiplatelet therapy after biolimus-eluting stent implantation for long or multivessel coronary artery disease
- Young Jin Youn, Jun-Won Lee, Sung Gyun Ahn, Seung-Hwan Lee, Hyunmin Choi, Cheol Woong Yu, Young Joon Hong, Hyuck Moon Kwon, Myeong-Ki Hong, Yangsoo Jang, Junghan Yoon
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?