Abstract
BackgroundBalloon aortic valvuloplasty (BAV) offers an alternative to conventional aortic valve replacement in elderly and frail patients with severe aortic stenosis (AS) for whom there are no other effective options. We aimed to investigate the mid-term effect of BAV on mitral regurgitation (MR) in patients with severe AS.MethodsOur analysis was based on the data from 83 patients with severe AS (mean age, 86 ± 5 years; female, 68) treated using BAV. Echocardiography was performed before the procedure and at 1 and 3 months after. MR was quantified by measuring the MR jet area, with more-than-moderate MR being clinically significant.ResultsForty patients were classified in this group (MR group). Significant reduction of MR was observed in the MR group at 1 month and 3 months after procedure, with no improvement in patients in the non-MR group. At 3 months, 15 of the 40 patients in the MR group still had significant MR, with the change at 1 month in the left ventricular end-systolic dimension (OR: 1.36; 95% CI: 1.05–1.76; P = 0.022) and MR jet area (OR: 1.95; 95% CI: 1.16–3.29; P = 0.012) being predictive of persisting significant MR at 3 months after BAV. The prevalence of New York Heart Association functional class III or IV decreased at 1 and 3 months after BAV in both groups.ConclusionsBAV provides a useful therapeutic strategy for elderly patients with severe AS who are not candidates for surgical or transcatheter aortic valve replacement, especially in those with significant MR.
Highlights
Balloon aortic valvuloplasty (BAV) offers an alternative to conventional aortic valve replacement in elderly and frail patients with severe aortic stenosis (AS) for whom there are no other effective options
Echocardiography was performed before BAV, and at 1 and 3 months after BAV, with standard measurements obtained in accordance with the current guidelines of the American Society of Echocardiography/ European Association of Cardiovascular Imaging [9]
The indications for BAV included a bridge-to-surgical aortic valve replacement (SAVR) or -the article aortic valve replacement (TAVR) (n = 27), the intervention of choice (n = 27), risk reduction associated with non-cardiac surgery (n = 17), and for diagnostic purposes (n = 12)
Summary
Balloon aortic valvuloplasty (BAV) offers an alternative to conventional aortic valve replacement in elderly and frail patients with severe aortic stenosis (AS) for whom there are no other effective options. We aimed to investigate the mid-term effect of BAV on mitral regurgitation (MR) in patients with severe AS. Balloon aortic valvuloplasty (BAV) is offered as an alternative to conventional surgical aortic valve replacement (SAVR) or transcatheter. Mitral regurgitation (MR) is commonly observed in patients with severe AS [5]. The risk for mortality increases in patients with severe AS in whom MR fails to improve after SAVR or TAVR [6,7,8].
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