Long-Term Mortality, Cause of Death, and Temporal Trends in Complications after Percutaneous Aortic Balloon Valvuloplasty for Calcific Aortic Stenosis

Division of Cardiology, Department of Medicine, University of California at San Francisco Medical Center, San Francisco, California, USA.
Journal of Interventional Cardiology (Impact Factor: 1.18). 06/2006; 19(3):269-75. DOI: 10.1111/j.1540-8183.2006.00142.x
Source: PubMed


We sought to assess survival, predictors of adverse outcomes, and complication rates in a more recent series of adults undergoing percutaneous aortic balloon valvuloplasty (PABV) for symptomatic calcific aortic stenosis. While aortic valve replacement is the treatment of choice for adults with symptomatic calcific aortic stenosis, PABV has been used in selected patients who are not good surgical candidates. Registries of patients who underwent PABV over 15 years ago have shown poor long-term survival and high procedural complication rates. This single-center cohort study enrolled consecutive adults undergoing PABV between 1989 and 2005 for calcific aortic stenosis. Demographic, hemodynamic, and procedural data, as well as vital status, were collected by chart review and query of the National Death Index. The study included 78 patients: mean age 78 +/- 11 years, 51% female, 90% heart failure, 61% coronary disease, and 8% end-stage renal disease. While 22% had a major procedural complication, this rate tended to decrease over time (P=0.068). In the cohort, 87% died with a median survival of 6.6 months. According to NDI records, the primary cause of death was cardiac in 54% of deaths. Survival was significantly higher in patients <or=70 years and those bridged to aortic valve replacement. PABV in patients who are elderly and not candidates for bridge to aortic valve replacement is associated with poor long-term survival. The decrease in the complication rate over the past 15 years has important implications regarding the morbidity associated with percutaneous aortic valve replacement techniques.

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    • "Presenting a significant risk to the life of the patient, but less frequent complications, are stroke (1-2%), myocardial infarction (1%), cardiac tamponade (1%) and significant acute aortic regurgitation (1%) [38, 39, 43, 45]. The operator's experience and technological progress have significantly improved the safety of the procedure [36, 45, 47, 48], as exemplified by the decline in the incidence of serious vascular complications from 13.5% in the 1990s to 4.6-7% observed currently [38, 39, 45, 46]. As a result, the periprocedural mortality is only approx. "
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    No preview · Article · May 2008 · Clinical Research in Cardiology
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