Percutaneous balloon valvuloplasty for calcific aortic stenosis. A treatment ‘sine cure’?
Twenty-five elderly patients with calcific aortic stenosis, 12 made (48%) and 13 female (52%), mean age 74.8±7.6 years, underwent percutaneous aortic balloon valvuloplasty between March 1986 and September 1987. Twenty-two patients (88%) were in class III–IV of the New York Heart Association, 13 (52%...
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| Veröffentlicht in: | European heart journal 1988-07, Vol.9 (7), p.782-794 |
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| creator | SERRUYS, P. W. LUIJTEN, H. E. BEATT, K. J. DI MARIO, C. DE FEYTER, P. J. ESSED, C. E. ROELANDT, J. R. T. C. VAN DEN BRAND, M. |
| description | Twenty-five elderly patients with calcific aortic stenosis, 12 made (48%) and 13 female (52%), mean age 74.8±7.6 years, underwent percutaneous aortic balloon valvuloplasty between March 1986 and September 1987. Twenty-two patients (88%) were in class III–IV of the New York Heart Association, 13 (52%) had a history of previous angina and 7 (28%) of syncopal attacks. All patients has been considered either unsuitable or high-risk candidates for aortic-valve replacement because of age or associated diseases. Balloons of increasing size (area ranging from 1.3 to 3.8 cm2 during inflation) were successively passed retrogradely from the femoral artery and manually inflated to 3–7 atmospheres. Inflation duration ranged from 15 to 260 s (mean 40 s). Post-dilatation there were significant changes in left ventricular peak-systolic and end-diastolic pressures (P |
| doi_str_mv | 10.1093/eurheartj/9.7.782 |
| format | Article |
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A treatment ‘sine cure’?</title><source>Oxford University Press Journals Digital Archive legacy</source><source>MEDLINE</source><creator>SERRUYS, P. W. ; LUIJTEN, H. E. ; BEATT, K. J. ; DI MARIO, C. ; DE FEYTER, P. J. ; ESSED, C. E. ; ROELANDT, J. R. T. C. ; VAN DEN BRAND, M.</creator><creatorcontrib>SERRUYS, P. W. ; LUIJTEN, H. E. ; BEATT, K. J. ; DI MARIO, C. ; DE FEYTER, P. J. ; ESSED, C. E. ; ROELANDT, J. R. T. C. ; VAN DEN BRAND, M.</creatorcontrib><description>Twenty-five elderly patients with calcific aortic stenosis, 12 made (48%) and 13 female (52%), mean age 74.8±7.6 years, underwent percutaneous aortic balloon valvuloplasty between March 1986 and September 1987. Twenty-two patients (88%) were in class III–IV of the New York Heart Association, 13 (52%) had a history of previous angina and 7 (28%) of syncopal attacks. All patients has been considered either unsuitable or high-risk candidates for aortic-valve replacement because of age or associated diseases. Balloons of increasing size (area ranging from 1.3 to 3.8 cm2 during inflation) were successively passed retrogradely from the femoral artery and manually inflated to 3–7 atmospheres. Inflation duration ranged from 15 to 260 s (mean 40 s). Post-dilatation there were significant changes in left ventricular peak-systolic and end-diastolic pressures (P<0.00001 and P<0.01, respectively), mean systolic aortic transvalvular gradient (from 73 to 43 mm Hg, P<0.000001). Major complications included: in-hospital deaths of two patients (8%) admitted in cardiogenic shock; left haemiplegia (4%); transient haemianopia (8%); development of grade III aortic insufficiency (4%); and presistent complete atrioventricular block (4%). Complications at the puncture-site occurred in 7 patients (28%)—including two femoral pseudoaneurysms and the need for surgical removal of a balloon remnant after rupture in one patient. No local haemorrhagic complications were observed in the latter eight procedures, performed using a 16.5 French 100-cm long arterial introducer. At a mean follow-up of 13.0±5.0 months, an important functional improvement persisted in 14 patients (56%), no major changes in pre-valvuloplastry symptoms were observed in 3 patients (12%), while five patients (20%) required surgical treatment after a successful valvuloplasty because of recurrence of symptoms (late valve restenosis). Percutaneous aortic balloon valvuloplasty is a possible palliative theraphy in elderly patients with calcific aortic stenosis. However, its inherent immediate risk, limited haemodynamic result and the possible development of valve restenosis at medium-term follow-up, suggest that the application of this technique should be limited to poor surgical candidated.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/9.7.782</identifier><identifier>PMID: 3169047</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Aged ; Aortic Valve Stenosis - pathology ; Aortic Valve Stenosis - therapy ; Aortic valvuloplasty ; Calcinosis - therapy ; Catheterization - adverse effects ; complications ; Female ; follow-up ; Follow-Up Studies ; Hemodynamics ; Humans ; Male ; Prognosis</subject><ispartof>European heart journal, 1988-07, Vol.9 (7), p.782-794</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c377t-f58c1cd9afb6d68360fad5b5bd0a5a1734eead107a41c05a7e53a7e5be681a983</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/3169047$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SERRUYS, P. W.</creatorcontrib><creatorcontrib>LUIJTEN, H. E.</creatorcontrib><creatorcontrib>BEATT, K. J.</creatorcontrib><creatorcontrib>DI MARIO, C.</creatorcontrib><creatorcontrib>DE FEYTER, P. J.</creatorcontrib><creatorcontrib>ESSED, C. E.</creatorcontrib><creatorcontrib>ROELANDT, J. R. T. C.</creatorcontrib><creatorcontrib>VAN DEN BRAND, M.</creatorcontrib><title>Percutaneous balloon valvuloplasty for calcific aortic stenosis. A treatment ‘sine cure’?</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description>Twenty-five elderly patients with calcific aortic stenosis, 12 made (48%) and 13 female (52%), mean age 74.8±7.6 years, underwent percutaneous aortic balloon valvuloplasty between March 1986 and September 1987. Twenty-two patients (88%) were in class III–IV of the New York Heart Association, 13 (52%) had a history of previous angina and 7 (28%) of syncopal attacks. All patients has been considered either unsuitable or high-risk candidates for aortic-valve replacement because of age or associated diseases. Balloons of increasing size (area ranging from 1.3 to 3.8 cm2 during inflation) were successively passed retrogradely from the femoral artery and manually inflated to 3–7 atmospheres. Inflation duration ranged from 15 to 260 s (mean 40 s). Post-dilatation there were significant changes in left ventricular peak-systolic and end-diastolic pressures (P<0.00001 and P<0.01, respectively), mean systolic aortic transvalvular gradient (from 73 to 43 mm Hg, P<0.000001). Major complications included: in-hospital deaths of two patients (8%) admitted in cardiogenic shock; left haemiplegia (4%); transient haemianopia (8%); development of grade III aortic insufficiency (4%); and presistent complete atrioventricular block (4%). Complications at the puncture-site occurred in 7 patients (28%)—including two femoral pseudoaneurysms and the need for surgical removal of a balloon remnant after rupture in one patient. No local haemorrhagic complications were observed in the latter eight procedures, performed using a 16.5 French 100-cm long arterial introducer. At a mean follow-up of 13.0±5.0 months, an important functional improvement persisted in 14 patients (56%), no major changes in pre-valvuloplastry symptoms were observed in 3 patients (12%), while five patients (20%) required surgical treatment after a successful valvuloplasty because of recurrence of symptoms (late valve restenosis). Percutaneous aortic balloon valvuloplasty is a possible palliative theraphy in elderly patients with calcific aortic stenosis. However, its inherent immediate risk, limited haemodynamic result and the possible development of valve restenosis at medium-term follow-up, suggest that the application of this technique should be limited to poor surgical candidated.</description><subject>Aged</subject><subject>Aortic Valve Stenosis - pathology</subject><subject>Aortic Valve Stenosis - therapy</subject><subject>Aortic valvuloplasty</subject><subject>Calcinosis - therapy</subject><subject>Catheterization - adverse effects</subject><subject>complications</subject><subject>Female</subject><subject>follow-up</subject><subject>Follow-Up Studies</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Male</subject><subject>Prognosis</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1988</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kM1OGzEUha2qKA2BB-iiklfdTbDjsT2zqhCiAQUJFkEgJGTd8dxRhzrj1PagsuMx4PV4EiZKlM09i_Mj3Y-Q75xNOSvFCfbhD0JITyflVE91MftCxlzOZlmpcvmVjBkvZaZUcf-NHMb4xBgrFFcjMhJclSzXY_J4g8H2CTr0faQVOOd9R5_BPffOrx3E9EIbH6gFZ9umtRR8SIPEhJ2PbZzSU5oCQlphl-jH61tsO6S2D_jx-v7riBw04CIe73RCbn-fL88usqvr-eXZ6VVmhdYpa2Rhua1LaCpVq0Io1kAtK1nVDCRwLXJEqDnTkHPLJGiUYnMqVAWHshAT8nO7uw7-X48xmVUbLTq3_cvoIs-lYGII8m3QBh9jwMasQ7uC8GI4MxukZo_UlEYPxdnQ-bEb76sV1vvGjuHgZ1u_HaD839sQ_hqlhZbm4v7BzBf8bsEXc7MUn9GviGs</recordid><startdate>198807</startdate><enddate>198807</enddate><creator>SERRUYS, P. W.</creator><creator>LUIJTEN, H. E.</creator><creator>BEATT, K. J.</creator><creator>DI MARIO, C.</creator><creator>DE FEYTER, P. J.</creator><creator>ESSED, C. E.</creator><creator>ROELANDT, J. R. T. C.</creator><creator>VAN DEN BRAND, M.</creator><general>Oxford University Press</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>198807</creationdate><title>Percutaneous balloon valvuloplasty for calcific aortic stenosis. A treatment ‘sine cure’?</title><author>SERRUYS, P. W. ; LUIJTEN, H. E. ; BEATT, K. J. ; DI MARIO, C. ; DE FEYTER, P. J. ; ESSED, C. E. ; ROELANDT, J. R. T. 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J.</creatorcontrib><creatorcontrib>DI MARIO, C.</creatorcontrib><creatorcontrib>DE FEYTER, P. J.</creatorcontrib><creatorcontrib>ESSED, C. E.</creatorcontrib><creatorcontrib>ROELANDT, J. R. T. C.</creatorcontrib><creatorcontrib>VAN DEN BRAND, M.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SERRUYS, P. W.</au><au>LUIJTEN, H. E.</au><au>BEATT, K. J.</au><au>DI MARIO, C.</au><au>DE FEYTER, P. J.</au><au>ESSED, C. E.</au><au>ROELANDT, J. R. T. C.</au><au>VAN DEN BRAND, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Percutaneous balloon valvuloplasty for calcific aortic stenosis. A treatment ‘sine cure’?</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>1988-07</date><risdate>1988</risdate><volume>9</volume><issue>7</issue><spage>782</spage><epage>794</epage><pages>782-794</pages><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Twenty-five elderly patients with calcific aortic stenosis, 12 made (48%) and 13 female (52%), mean age 74.8±7.6 years, underwent percutaneous aortic balloon valvuloplasty between March 1986 and September 1987. Twenty-two patients (88%) were in class III–IV of the New York Heart Association, 13 (52%) had a history of previous angina and 7 (28%) of syncopal attacks. All patients has been considered either unsuitable or high-risk candidates for aortic-valve replacement because of age or associated diseases. Balloons of increasing size (area ranging from 1.3 to 3.8 cm2 during inflation) were successively passed retrogradely from the femoral artery and manually inflated to 3–7 atmospheres. Inflation duration ranged from 15 to 260 s (mean 40 s). Post-dilatation there were significant changes in left ventricular peak-systolic and end-diastolic pressures (P<0.00001 and P<0.01, respectively), mean systolic aortic transvalvular gradient (from 73 to 43 mm Hg, P<0.000001). Major complications included: in-hospital deaths of two patients (8%) admitted in cardiogenic shock; left haemiplegia (4%); transient haemianopia (8%); development of grade III aortic insufficiency (4%); and presistent complete atrioventricular block (4%). Complications at the puncture-site occurred in 7 patients (28%)—including two femoral pseudoaneurysms and the need for surgical removal of a balloon remnant after rupture in one patient. No local haemorrhagic complications were observed in the latter eight procedures, performed using a 16.5 French 100-cm long arterial introducer. At a mean follow-up of 13.0±5.0 months, an important functional improvement persisted in 14 patients (56%), no major changes in pre-valvuloplastry symptoms were observed in 3 patients (12%), while five patients (20%) required surgical treatment after a successful valvuloplasty because of recurrence of symptoms (late valve restenosis). Percutaneous aortic balloon valvuloplasty is a possible palliative theraphy in elderly patients with calcific aortic stenosis. However, its inherent immediate risk, limited haemodynamic result and the possible development of valve restenosis at medium-term follow-up, suggest that the application of this technique should be limited to poor surgical candidated.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>3169047</pmid><doi>10.1093/eurheartj/9.7.782</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | European heart journal, 1988-07, Vol.9 (7), p.782-794 |
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| language | eng |
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| subjects | Aged Aortic Valve Stenosis - pathology Aortic Valve Stenosis - therapy Aortic valvuloplasty Calcinosis - therapy Catheterization - adverse effects complications Female follow-up Follow-Up Studies Hemodynamics Humans Male Prognosis |
| title | Percutaneous balloon valvuloplasty for calcific aortic stenosis. A treatment ‘sine cure’? |
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