[Early clinical outcomes of percutaneous balloon aortic valvuloplasty in treating high-risk patients with severe aortic stenosis].

ABSTRACT

OBJECTIVE: To explore the procedural feasibility and early clinical outcomes of percutaneous balloon aortic valvuloplasty (PBAV) in patients with severe aortic stenosis, who were considered transiently unsuitable for surgical aortic valve replacement (sAVR) and transcatheter aortic valve replacement (TAVR). METHODS: Between March 2011 and January 2014, datas of 20 patients underwent PBAV in Fuwai Hospital were retrospectively analyzed. Mean patients age was (72 ± 8) years.Initial procedural and clinical outcomes were evaluated. RESULTS: PBAV was successfully performed in all cases. Post-procedure, aortic valve area increased from (0.55 ± 0.09) m(2) to (0.77 ± 0.15) m(2)(P < 0.001), left ventricle ejection fraction from (31.7 ± 9.0) % to (39.0 ± 11.0) % (P = 0.018), mean transaortic valve gradient decreased from (49.5 ± 15.0) mmHg (1 mmHg = 0.133 kPa) to (31.7 ± 12.0) mmHg (P < 0.001), and pulmonary artery systolic pressure decreased from (55.1 ± 18.0) mmHg to (38.7 ± 11.0) mmHg (P = 0.025) . There was no significant change in the aortic regurgitation grade (P = 0.854). The most common complications were hypotension (n = 4) and transient left bundle branch block (n = 5). Overall 24-hour and 30-day mortality was 5% (n = 1) and 15% (n = 3), respectively. Within 30 days after PBAV procedure, five patients underwent successful sAVR, one patient underwent TAVR, and five patients awaited TAVR. CONCLUSION: In high-risk patients with severe aortic stenosis and temporary contraindication to sAVR or TAVR, PBAV can be safely used as a bridging intervention procedure and the short-term procedural and clinic outcomes are satisfactory.