Percutaneous transluminal aortic valvuloplasty: acute outcome and follow-up of 125 patients.

Journal of the American College of Cardiology
R F LewinL Mathiak

Abstract

Percutaneous transluminal aortic valvuloplasty was performed on 125 patients (59 men [47%], mean age 76 +/- 13 years) between July 1986 and May 1988, with presenting symptoms of severe congestive heart failure in 88 (70%), moribund state in 15 (12%) and syncope in 17 (14%). Surgical valve replacement was considered unsuitable in 79% of cases. A multiple balloon technique was utilized in 119 patients (95%). Valvuloplasty produced significant changes in peak pressure gradient (87 +/- 38 to 32 +/- 17 mm Hg), mean pressure gradient (70 +/- 26 to 30 +/- 13 mm Hg) and valve area (0.6 +/- 0.2 to 1.0 +/- 0.3 cm2). Complications included: in-hospital mortality in 10% (6 of 13 deaths in moribund patients), neurologic deficit in 3% and myocardial infarction in 2%. Arterial repair was required at 12 (4%) of 325 entry sites. Multivariate analysis identified severe congestive heart failure, preprocedure left ventricular ejection fraction and cardiac output as the only independent variables significantly affecting mortality. The cumulative probability of survival at 12 months was 62 +/- 6% and, excluding non-cardiac deaths, was 77 +/- 5%. At a mean of 12 +/- 4 months' follow-up, 55 of 72 patients were symptomatically improved; 10 patients wit...Continue Reading

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Citations

Jan 1, 1992·Catheterization and Cardiovascular Diagnosis·R E KuntzR D Safian
Aug 1, 1992·Catheterization and Cardiovascular Diagnosis·R KoningB Letac
Oct 1, 1990·Journal of the American College of Cardiology·K H SheikhT M Bashore
Jul 4, 1991·The New England Journal of Medicine·R E KuntzR D Safian
Apr 1, 1993·The New England Journal of Medicine·J B WongS G Pauker
Feb 7, 1993·Journal of Interventional Cardiology·E B Diethrich
Jul 14, 2010·Journal of Interventional Cardiology·Samir R KapadiaE Murat Tuzcu
Jun 1, 1994·The American Journal of Cardiology·H M RosenfeldJ E Lock
Nov 26, 2009·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Christian WitzkeIgor F Palacios
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Jul 1, 1991·The American Journal of Cardiology·C J DavidsonT M Bashore
Nov 23, 2010·JACC. Cardiovascular Interventions·Fabian NietlispachJohn G Webb

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