Restenosis is a Common Feature of the Angiographic Follow-up After Balloon Valvoplasty of Calcified Aortic Stenoses

  • H. Sievert
  • P. Krämer
  • G. Kober
  • W.-D. Bussmann
  • M. Kaltenbach

Abstract

Balloon dilatation of calcified aortic stenosis was attempted in 12 patients, 6 men and 6 women, aged 38–82 years. Two patients underwent emergency surgery because of myocardial injury or pericardial tamponade. One patient with severe depressed left ventricular function in whom the procedure was attempted in cardiogenic shock died during the procedure. One patient experienced severe aortic insufficiency after dilatation. The remaining pressure gradient was higher than 50 mmHg in another patient. Seven dilatations were considered to be successful with a remaining pressure gradient below 50 mmHg and a mean gradient reduction of 53 mmHg. In one of these 7 patients, who suffered from severe heart failure, valvoplasty had been carried out to make aortic valve replacement possible. The operation was performed 2 weeks later without complications. Five of 6 patients treated medically after successful valvoplasty had restenosis within 3 to 12 months. One of them exhibited a good result at 3 months but severe restenosis after one year. It is concluded that balloon valvoplasty of calcified aortic stenosis cannot be considered an alternative to surgery. If, however, left ventricular function improves after successful valvoplasty, valve replacement will then carry less risk.

Key words

Aortic stenosis Valvoplasty Balloon dilatation Long-term results 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Cribier A, Saoudi N, Berland J, Savin T, Rocha P, Letac B. Percutaneous transluminal valvuloplasty of acquired aortic stenosis in elderly patients: an alternative to valve replacement? Lancet 1986; 63–73Google Scholar
  2. 2.
    Berland J, Cribier A, Letac B, Guermonprey JL. Percutaneous aortic valvuloplasty in adults: immediate results of the French ’ registry. Eur Heart J 1987; 8, (suppl 2): 241Google Scholar
  3. 3.
    Cribier A, Berland, J, Savin T. Mechmeche R, Saoudi N, Letac B. Percutaneous transluminal aortic valvuloplasty in adult aortic stenosis: results in 130 patients. J Am Coll Cardiol 1987; 9: 13AGoogle Scholar
  4. 4.
    Cribier A, Savin T, Berland J, et al. Percutaneous transluminal balloon valvuloplasty of adult aortic stenosis: report of 92 cases. J Am Coll Cardiol 1987; 9: 381–386PubMedCrossRefGoogle Scholar
  5. 5.
    Erdmann E, Höfling B. Perkutane transfemorale Valvuloplastie der verkalkten und nicht verkalkten Aortenklappe. Dtsch Med Wochenschr 1987; 112: 1067–1072PubMedCrossRefGoogle Scholar
  6. 6.
    Isner JM, Salem DN, Desnoyers MR, et al. Treatment of calcific aortic stenosis by balloon valvuloplasty. Am J Cardiol 1987; 59: 313–317PubMedCrossRefGoogle Scholar
  7. 7.
    Jackson G, Thomas S, Monaghan M, Forsyth A, Jewit D. Inoperable aortic stenosis in the elderly: benefit from percutaneous transluminal valvuloplasty. Br Med J 1987; 294: 83–86CrossRefGoogle Scholar
  8. 8.
    McKay RG, Safian RD, Lock JE et al. Balloon dilatation of calcified aortic stenosis in elderly patients: postmortem, intra-operative, and percutaneous valvuloplasty studies. Circulation 1986; 74: 119–125PubMedCrossRefGoogle Scholar
  9. 9.
    Neuhaus KL. Aorten-und Mitralklappendilatationen. Vortrag Herbsttagung der Dtsch Ges f Herz-und Kreislaufforschung. Freiburg, 8–10 October 1987Google Scholar
  10. 10.
    Nishimura RA, Holmes DR, Reeder GS. Follow-up of patients undergoing percutaneous aortic balloon valvuloplasty by Doppler echocardiography. J Am Coll Cardiol 1988; 11: 234 AGoogle Scholar
  11. 11.
    Scherer HE, Hörmann E, Schwarten JU, Engel HJ. Perkutane Valvuloplastie verkalkter Aortenklappenstenosen: Alternative zum operativen Herzklappenersatz? Z Kardiol 1987; 76 (suppl 2): 59Google Scholar
  12. 12.
    Vahanian A, Guerinon J, Michel PL, Slama M, Grivaux M, Acar J. Experimental balloon valvoluplasty of calcified aortic stenosis in the elderly. Circulation 1986; 74 (suppl 11): 365Google Scholar
  13. 13.
    Sievert H, Kaltenbach M, Bussmann W-D., Kober G. Perkutane Valvuloplastik der Aortenklappe im Erwachsenenalter. Dtsch Med Wochschr. 1986; 111: 504–506CrossRefGoogle Scholar
  14. 14.
    Bussmann W-D, Reifart N, Sievert H, Kaltenbach M. Trans-femorale Valvuloplastik bei verkalkter Aortenklappenstenose. Dtsch Med Wochenschr 1987; 112: 723–725PubMedCrossRefGoogle Scholar
  15. 15.
    Sievert H, Kober G, Kaltenbach M. Transluminale Valvuloplastik einer stenosierten und verkalkte Aortenklappe. Med Klinik 1986; 81: 855–857Google Scholar
  16. 16.
    Berman AD, Safian RD, Diver DJ, et al. Balloon aortic valvuloplasty of calcific aortic stenosis: results in 100 cases. Circulation 1987; 76 (suppl IV): 496Google Scholar
  17. 17.
    Bernard Y, Bassand JP, Anguenot T. et al. Early and late evaluation of percutaneous aortic valvuloplasty. A combined hemodynamic and doppler-echocardiographic study. J Am Coll Cardiol 1988; 11: 14 AGoogle Scholar
  18. 18.
    Berland J, Cribier A, Savin T. et al. Postvalvuloplasty follow-up of elderly patients with severe aortic stenosis and low ejection fraction. J Am Coll Cardiol 1988; 11: 15 AGoogle Scholar
  19. 19.
    Berman AD, Safian RD. Diver DJ, et al. Balloon aortic valvuloplasty of calcific aortic stenosis: results in 130 cases. J Am Coll Cardiol 1988; 11: 16 AGoogle Scholar
  20. 20.
    Lancelin B, Chevalier B, Bourdin T, et al. Mid-term follow-up after percutaneous transluminal aortic valvuloplasty in the elderly. J Am Coll Cardiol 1988; 11: 234 AGoogle Scholar
  21. 21.
    Letac B, Berland J, Mechmeche R, Savin T, Saoudi N, Cribier A. Late hemodynamic evaluation after percutaneous aortic valvuloplasty in adults with aortic stenosis. J Am Coll Cardiol 1987; 9: 14AGoogle Scholar
  22. 22.
    Hamm CW, Langes K, Kupper W, Kalmar P, Bleifeld W. Morphologische Veränderungen bei Balloon-Valvuloplastie verkalkter Aortenklappenstenosen. Z Kardiol 1987; 76 (suppl 2): 21Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • H. Sievert
  • P. Krämer
  • G. Kober
  • W.-D. Bussmann
  • M. Kaltenbach

There are no affiliations available

Personalised recommendations