TY - JOUR
T1 - Clinical and noninvasive hemodynamic results after aortic balloon valvuloplasty for aortic stenosis
AU - Desnoyers, Mark R.
AU - Isner, Jeffrey M.
AU - Pandian, Natesa G.
AU - Wang, Shan Shen
AU - Hougen, Thomas
AU - Fields, Constance D.
AU - Lucas, Alexandra R.
AU - Salem, Deeb N.
N1 - Funding Information:
From the Departments of Medicine (Cardiology) and Pediatrics, Tufts University School of Medicine, New England Medical Center Hospital, Boston, Massachusetts. This study was supported in part by grant HL 32747-01 and contract NOl-HC-55010 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland. Work was performed during Dr. Fields’ tenure as Research Fellow of the American Heart Association’s Massachusetts Affiliate, Needham, Massachusetts. Dr. Lucas is the recipient of an Alberta Heritage Clinical Research Fellowship. Manuscript received April 19, 1988; revised manuscript received and accepted July 5, 1988.
PY - 1988/11/15
Y1 - 1988/11/15
N2 - Balloon valvuloplasty has been shown to be an effective treatment for adults with aortic stenosis, typically providing a 50 to 80% increase in aortic valve area and marked improvement in exertional dyspnea, angina and syncope. However, the duration of this hemodynamic and clinical improvement is uncertain. Forty-two patients were followed for 10.2 ± 0.5 months. Balloon valvuloplasty caused dramatic immediate reduction in the number of patients with moderate or severe dyspnea (80 to 14%), moderate or severe angina (39 to 2%) and syncope (30 to 2%). Furthermore, this improvement in symptoms continued for the duration of the follow-up period in most patients. Echocardiographic aortic valve mean gradient and area determined at 3-month intervals, however, showed a trend toward or return to prevalvuloplasty levels by 9 months' follow-up in 13 of 25 patients (52%), whereas 12 of 25 patients showed no deterioration in their hemodynamic parameters. This trend toward restenosis was accompanied by symptomatic deterioration in 5 of 13 patients (38%). This tendency toward restenosis in >50% of patients by 9 months underscores the need for further technical improvements if balloon valvuloplasty is to be widely applied. Even with these limitations, however, balloon valvuloplasty seems to provide a significant improvement in actuarial survival compared with the natural history of elderly patients with severe aortic stenosis.
AB - Balloon valvuloplasty has been shown to be an effective treatment for adults with aortic stenosis, typically providing a 50 to 80% increase in aortic valve area and marked improvement in exertional dyspnea, angina and syncope. However, the duration of this hemodynamic and clinical improvement is uncertain. Forty-two patients were followed for 10.2 ± 0.5 months. Balloon valvuloplasty caused dramatic immediate reduction in the number of patients with moderate or severe dyspnea (80 to 14%), moderate or severe angina (39 to 2%) and syncope (30 to 2%). Furthermore, this improvement in symptoms continued for the duration of the follow-up period in most patients. Echocardiographic aortic valve mean gradient and area determined at 3-month intervals, however, showed a trend toward or return to prevalvuloplasty levels by 9 months' follow-up in 13 of 25 patients (52%), whereas 12 of 25 patients showed no deterioration in their hemodynamic parameters. This trend toward restenosis was accompanied by symptomatic deterioration in 5 of 13 patients (38%). This tendency toward restenosis in >50% of patients by 9 months underscores the need for further technical improvements if balloon valvuloplasty is to be widely applied. Even with these limitations, however, balloon valvuloplasty seems to provide a significant improvement in actuarial survival compared with the natural history of elderly patients with severe aortic stenosis.
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U2 - 10.1016/0002-9149(88)90552-8
DO - 10.1016/0002-9149(88)90552-8
M3 - Article
C2 - 3189170
AN - SCOPUS:0023723910
SN - 0002-9149
VL - 62
SP - 1078
EP - 1084
JO - The American Journal of Cardiology
JF - The American Journal of Cardiology
IS - 16
ER -