Clinical and noninvasive hemodynamic results after aortic balloon valvuloplasty for aortic stenosis

Mark R. Desnoyers, Jeffrey M. Isner, Natesa G. Pandian, Shan Shen Wang, Thomas Hougen, Constance D. Fields, Alexandra R. Lucas, Deeb N. Salem

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1078-1084
Number of pages7
JournalThe American Journal of Cardiology
Volume62
Issue number16
DOIs
StatePublished - Nov 15 1988
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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