Percutaneous balloon aortic valvotomy

We report our first case of percutaneous balloon aortic valvotomy in a 72-year-old Chinese female with critical aortic stenosis and carcinoma of the stomach. The presence of critical aortic stenosis (mean aortic pressure gradient of 65 mmHg and an aortic valve area of 0.5 cm2) placed her at a high risk for gastrectomy. After balloon valvotomy of the aortic valve, the mean pressure gradient fell to 21 mmHg and the aortic valvular area increased to 1.0 cm2. She improved clinically and subsequently underwent surgery with no haemodynamic complication. Overseas experience has shown that percutaneous balloon valvotomy can be done with little technical difficulty and excellent patient tolerance, resulting in good haemodynamic and clinical improvement and a low acute complication rate. Present follow-up data however suggest significant mortality and restenosis rates at the end of one year. Percutaneous balloon aortic valvotomy (PBAV) has a significant though narrowly defined role in the management of patients with severe calcific aortic stenosis.