Feasibility of transcatheter intervention for severe aortic stenosis in patients ≥90 years of age: Aortic valvuloplasty revisited
| Autor: | Michael R. Mooney, Kevin J. Graham, Robert S. Schwartz, Talia A. Pierce, Wes R. Pedersen, John R. Lesser, Hidehiko Hara, Paul J. Klaassen, Kevin M. Harris, Robert A. Van Tassel, Vibhu R. Kshettry, Marc R. Priztker, Charlene R. Boisjolie, Irvin F. Goldenberg |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Population Balloon Risk Assessment Severity of Illness Index Catheterization Aortic valve replacement Internal medicine medicine Humans Radiology Nuclear Medicine and imaging education Aged 80 and over education.field_of_study Framingham Risk Score business.industry Patient Selection Age Factors Aortic Valve Stenosis General Medicine Perioperative medicine.disease Aortic valvuloplasty Surgery Stenosis Treatment Outcome Research Design Cardiothoracic surgery Cardiology Feasibility Studies Female Stents Cardiology and Cardiovascular Medicine business |
| Zdroj: | Catheterization and Cardiovascular Interventions. 70:151-156 |
| ISSN: | 1522-726X 1522-1946 |
| Popis: | Objectives: The goals of this study were to determine the feasibility, safety, and early outcomes of balloon aortic valvuloplasty (BAV) for severe aortic stenosis in a nonagenarian population. Background: This very elderly population is expanding rapidly, has a high incidence of aortic stenosis, and uncommonly undergoes surgical aortic valve replacement. These patients may best be treated with a transcatheter approach due to comorbidities, surgical risk, and personal preference. Methods: We reviewed 31 consecutive patients ≥≥90 years of age who underwent BAV at our institution from July 2003 to August 2006 for data pertinent to patient characteristics, procedural techniques, and 30-day outcomes. Results: Our patients had a mean age of 93 ± 3.0 years (90–101). The society of thoracic surgery risk score was 18.5 (±10.2) and logistic Euroscore was 35.8 (±19.3). Twenty-five patients (81%) underwent retrograde BAV and 6 (19%) antegrade BAV. Five patients (16%) underwent combined BAV and coronary stenting. Overall mean aortic valve area increased from 0.52 cm2 (±0.17) to 0.92 cm2 (±0.22) and mean New York Heart Association (NYHA) functional class improved from 3.4 to 1.8. Intraprocedural mortality occurred in one patient (3.2%) and 30-day mortality in three patients (9.7%). Conclusions: BAV can be carried out in high risk nonagenarian patients with an acceptable complication rate, low perioperative mortality, and early improvement in NYHA functional class. © 2007 Wiley-Liss, Inc. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text