Balloon valvuloplasty as destination therapy in elderly with severe aortic stenosis:a cardiac catheterization study
Vasileios Kamperidis
Stavros Hadjimiltiades
Antonios Ziakas
Georgios Sianos
Georgios Kazinakis
George Giannakoulas
Sophia-Anastasia Mouratoglou
Athanasia Sarafidou
Ioannis Ventoulis
Georgios K Efthimiadis
Georgios Parcharidis
Haralambos Karvounis
摘要：Background In the current era of transcatheter aortic valve replacement, there is renewed interest in balloon aortic valvuloplasty (BAV) and invasive hemodynamic evaluation of aortic stenosis (AS). The current report aimed to study the invasive hemodynamics of se-vere AS patients treated with BAV as destination therapy and to identify factors associated with better hemodynamic outcome and prognosis. Methods From 2009 to 2012, 63 high risk elderly patients were treated with BAV as destination therapy for symptomatic severe AS and were all prospectively included in the study. Their hemodynamics were invasively evaluated during catheterization, pre-and post-BAV at the same session. All Post-BAV patients were regularly followed-up. Results The patients (82 ± 6 years, 52%male) had post-BAV aortic valve area index (AVAi) significantly increased and mean pressure gradient (MPG) significantly reduced. During the follow-up of 0.9 (maximum 3.3) years, those with post-BAV AVAi<0.6 cm2/m2 compared with the AVAi≥0.6 cm2/m2 group had significantly higher mortality (60%vs. 28%, log-rank P=0.02), even after adjusting for age, gender, atrial fibrillation, chronic kidney disease, diabetes mellitus, coronary artery disease and EuroSCORE [HR:5.58, 95%confidence interval (CI):1.62?19.20, P=0.006]. The only independent predictor of moderate AS post-BAV was the pre-BAV AVAi increase by 0.1cm2/m2 (OR:3.81, 95%CI:1.33?10.89, P=0.01). Pre-BAV AVAi≥0.39 cm2/m2 could predict with sensitivity 84%and specificity 70%the post-BAV hemodynamic outcome. Conclusions BAV as destination therapy for se-vere AS offered immediate and significant hemodynamic improvement. The survival was significantly better when a moderate degree of AS was present.
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论文发表日期：2015-07-02
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：8( 218-225 )
英文信息