Aortic valve stenosis in the elderly: Balloon aortic valvuloplasty

2015 ◽  
pp. 274-293
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
The Elderly ◽  
Balloon Aortic Valvuloplasty ◽  
Aortic Valvuloplasty

Abstract 19440: Reintervention Rates Following Balloon Aortic Valvuloplasty versus Surgical Valve Repair in Isolated Congenital Aortic Valve Stenosis - A Meta-analysis

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
May T Saung ◽  
Courtney McCracken ◽  
Ritu Sachdeva ◽  
Christopher J Petit
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Stenosis ◽  
Meta Analysis ◽  
Valve Repair ◽  
Balloon Aortic Valvuloplasty ◽  
Congenital Aortic Stenosis ◽  
Primary Indication ◽  
Aortic Valvuloplasty

Introduction: The optimal treatment for congenital aortic stenosis (AS) is debated despite decades of experience with both balloon aortic valvuloplasty (BAV) and surgical aortic valve repair (SAV). While BAV has been the mainstay of therapy for AS, recent single-center reports suggest optimal results following SAV. Hypothesis: We propose that reintervention rates following SAV and BAV are equivalent. Methods: We queried Medline, EMBASE and Web of Science for eligible studies using the keywords: “congenital aortic stenosis”, “balloon valvotomy”, “aortic valve stenosis surgery” and “treatment outcome or reintervention”. Studies were excluded when cohort size was <20 pts, when follow-up was < 2.5 yrs from primary intervention, and when primary indication was not AS (e.g. SAV in the setting of aortic valve regurgitation (AR)). Outcomes analyzed included death, reintervention and moderate or severe AR. Analysis was performed using Comprehensive Meta Analysis v3 using random effects models. Results: A total of 20 studies were included in our meta-analysis: SAV alone (n=3), BAV alone (n=12), and both (n=5). The mean age at BAV was 3.1 years (range, 4 days - 7 years) with a mean follow-up duration of 6.8 years, while mean age at SAV was 2.8 years (range, 14.2 days - 7.1 years) with a mean follow-up duration of 9.1 years. Mortality rates following BAV and SAV were 12.3% (95% CI: 7.7 - 19.1) and 10.2% (95% CI: 7.0 - 14.5), respectively (p=0.27). Reintervention following initial procedure for treatment of AS was higher following BAV (35.7% [95% CI: 29 - 43.1]) compared to SAV (25.2% [95% CI: 19.9 - 31.3])(p=0.012). Long-term and mid-term follow-up in these studies showed moderate to severe AR was present in 24.1% and 28.1% of BAV and SAV patients, respectively. Conclusions: Notwithstanding publication bias, both survival rates and development of late AR following BAV and SAV are similar. However, reintervention rates are significantly higher following BAV compared to SAV.

scholarly journals Balloon valvuloplasty in two dogs with aortic valve stenosis showing congestive heart failure

2020 ◽  
Vol 65 (No. 2) ◽  
pp. 89-94
Author(s):  
T Yoshida ◽  
K Matsuura ◽  
S Goya ◽  
D Ma ◽  
K Shimada ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Clinical Symptoms ◽  
Aortic Flow ◽  
Balloon Valvuloplasty ◽  
Balloon Aortic Valvuloplasty ◽  
Aortic Valvuloplasty ◽  
Key Factor

A 10-year-old female Papillon and a 1-year-old male Golden Retriever were presented to the Tokyo University of Agriculture and Technology for a second opinion on an aortic valve stenosis (AS). The aortic flow rate was not as high as it should have been (the aortic flow velocity for case 1 and case 2 was 2.82 m/s and 3.96 m/s, respectively). However, the AS was suspected to be an exacerbating factor in the congestive heart failure, so that a balloon valvuloplasty was conducted. As a result, the congestion and clinical symptoms were much improved in both cases. In conclusion, in cases with an AS, in which afterload is a key factor for the exacerbation of the congestion, a balloon aortic valvuloplasty may reduce the afterload and consequently lead to an improvement in the congestion.

scholarly journals The Role of Balloon Aortic Valvuloplasty in Patients With Aortic Valve Stenosis and Society of Thoracic Surgeons Risk of 15% or Higher

2016 ◽  
Vol 101 (2) ◽  
pp. 592-598 ◽  
Author(s):  
Juan C. Araque ◽  
Kevin L. Greason ◽  
Rakesh M. Suri ◽  
David R. Holmes ◽  
Charanjit S. Rihal ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Balloon Aortic Valvuloplasty ◽  
Aortic Valvuloplasty

Balloon Aortic Valvuloplasty under Temporary Mechanical Circulatory Support as a Bridge to Aortic Valve Replacement in a Patient with Hemodynamic Failure Secondary to Critical Aortic Valve Stenosis

2012 ◽  
Vol 15 (3) ◽  
pp. 177 ◽  
Author(s):  
Salil Deo ◽  
Kevin L. Greason ◽  
Rajiv Gulati ◽  
Allan S. Jaffe ◽  
David R. Holmes
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Cardiogenic Shock ◽  
Valve Replacement ◽  
Aortic Valve Stenosis ◽  
Mechanical Circulatory Support ◽  
Definitive Treatment ◽  
Circulatory Support ◽  
Balloon Aortic Valvuloplasty ◽  
Aortic Valvuloplasty

Aortic valve replacement in the setting of critical aortic valve stenosis with cardiogenic shock is associated with high mortality, yet surgery is the only definitive treatment. We present the case of a patient with critical aortic valve stenosis and cardiogenic shock who received a short period of percutaneous mechanical support and balloon aortic valvuloplasty that resulted in rapid clinical improvement. The patient then underwent uneventful aortic valve replacement. We believe that temporary mechanical circulatory support coupled with balloon aortic valvuloplasty helped to restore hemodynamic stability before surgery, leading to a better outcome.

scholarly journals Evaluation of initial and medium-term follow-up results of balloon aortic valvuloplasty in severe aortic valve stenosis in newborns, infants and children in Alexandria, Egypt

2019 ◽  
Vol 6 (5) ◽  
pp. 1863
Author(s):  
Hani Mahmoud Adel
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Heart Diseases ◽  
Infants And Children ◽  
Medium Term ◽  
Balloon Aortic Valvuloplasty ◽  
Inflated Balloon ◽  
Valvular Stenosis ◽  
Aortic Valvuloplasty ◽  
The Mean

Background: Aortic valve stenosis (AVS) represents 3%–7% of all congenital heart diseases. Balloon aortic valvuloplasty (BAoV) has been established as an alternative to surgery for therapy of AVS in infants and children; and has proven to be an effective method for decreasing the gradient between the left ventricle and the aorta. The objective of the study was to evaluate the initial and medium-term results of BAoV in newborns, infants and children with severe AS, treated at the Alexandria University Children’s Hospital.Methods: Thirty-seven newborns, infants and children with severe AS treated by B AoV between 2009 and 2017 were studied. They were followed-up for at least 1year post- ballooning by clinical and echocardiographic evaluation.Results: The mean AoV annulus diameter by echo was 13.1±4.4 mm and by angiographic measurement was 12.8±4.3 mm. The mean Doppler gradient across AoV was 91.8±14.7 mmHg, compared to mean catheter gradient of 66.1±13.4 mmHg. The mean inflated balloon diameter was 12.1±4.1 mm. The mean balloon/AoV annulus ratio by angiogram was 0.94±0.03 (0.88–1). The mean pressure gradient across the AoV post-ballooning was 21.5±6.9 mmHg by Doppler and was 10.3±4.7 mmHg by catheter, both were significantly less than pre-ballooning values (p<0.001). The procedure was successful in all the cases. Only one case died. Post -ballooning aortic incompetence was moderate in 2 cases (5.4%) and severe in only one case (2.7%).Conclusions: Balloon aortic valvuloplasty is an effective and safe technique for relieving severe aortic valvular stenosis with acceptable morbidity and minimal mortality, particularly with the new catheter and balloon technology.

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