Efficacy of antegrade percutaneous transluminal aortic valvuloplasty in high-risk hemodialysis patients undergoing open heart surgery

The purpose of this study is to examine the effectiveness and safety of antegrade percutaneous transluminal aortic valvuloplasty (ante-PTAV) in maintenance dialysis patients. From among all cases of ante-PTAV at our facility between November 2009 and March 2014, we focused on 20 cases of patients on dialysis. Between pre- and post-surgical pressure gradient measurements, the level of severity of AS improved on average from 55.6±15.4 mmHg to 19.0±9.9 mmHg, the average aortic valve area increased from 0.69±0.17 cm2 to 1.24±0.34 cm2, and the average NYHA classification improved from 3.4±0.68 to 1.75±0.85, while the lowest intradialysis systolic blood pressure improved from 96.6±22 mmHg prior to treatment to 112.2±24.9 mmHg after treatment. On the other hand, death resulted in one case, and other complications were observed in 3 cases. Restenosis was noted in two cases following surgery, as a result of which, ante-PTAV was implemented again. For patients on maintenance dialysis complicated by severe AS, ante-PTAV is a minimally invasive and safe procedure. Observations indicated that the treatment is effective in bringing about improvements in clinical conditions and eliminating some difficulties of dialysis.