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Aortic Balloon

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Igor F Palacios – One of the best experts on this subject based on the ideXlab platform.

  • the role of percutaneous Aortic Balloon valvuloplasty in patients with cardiogenic shock and critical Aortic stenosis
    Journal of the American College of Cardiology, 1994
    Co-Authors: Pedro R Moreno, Ikkyung Jang, John B Newell, Peter C Block, Igor F Palacios

    Abstract:

    Abstract Objectives. The goal of this study was to evaluate the role of percutaneous Aortic valvuloplasty in patients with cardiogenic shock due to severe Aortic stenosis and associated major comorbid conditions and to establish predictors of survival. Background. The prognosis for patients in cardiogenic shock with severe Aortic stenosis is poor. Aortic valve replacement can be lifesaving but the presence of multiorgan failure precludes these patients from operation. Percutaneous Aortic Balloon valvuloplasty has been used in these patients with short-term improvement and could be an alternative therapeutic option. Methods. Of 310 patients undergoing percutaneous Aortic Balloon valvuloplasty, 21 were in cardiogenic shock and were included in this study. All 21 patients had associated major comorbid conditions at the time of presentation. Results. After percutaneous Aortic Balloon valvuloplasty, systolic Aortic pressure increased from 77 ± 3 (mean ± SEM) to 116 ± 8 mm Hg (p = 0.0001); Aortic valve area increased from 0.48 ± 0.04 to 0.84 ± 0.06 cm2(p = 0.0001); and cardiac index increased from 1.84 ± 0.13 to 2.24 ± 0.15 liters/min per m2(p = 0.06). Nine patients died in the hospital, two during the procedure and seven after successful percutaneous Aortic Balloon valvuloplasty (five from multiorgan failure). Five patients had vascular complications. Stroke, cholesterol emboli and Aortic regurgitation requiring Aortic valve replacement occurred in one patient each. Twelve patients (57%) survived and were followed up for 15 ± 6 months; five patients subsequently died. The Kaplan-Meier survival curve showed a 38 ± 11% survival rate at 27 months. The only predictor for longer survival rate was the postprocedure cardiac index. Conclusions. 1) Emergency percutaneous Aortic Balloon valvuloplasty can be performed successfully as a lifesaving procedure. 2) Morbidity and mortality remain high despite successful percutaneous Aortic Balloon valvuloplasty. 3) For nonsurgical candidates, percutaneous Aortic Balloon valvuloplasty may be the only therapeutic alternative.

Pedro R Moreno – One of the best experts on this subject based on the ideXlab platform.

  • the role of percutaneous Aortic Balloon valvuloplasty in patients with cardiogenic shock and critical Aortic stenosis
    Journal of the American College of Cardiology, 1994
    Co-Authors: Pedro R Moreno, Ikkyung Jang, John B Newell, Peter C Block, Igor F Palacios

    Abstract:

    Abstract Objectives. The goal of this study was to evaluate the role of percutaneous Aortic valvuloplasty in patients with cardiogenic shock due to severe Aortic stenosis and associated major comorbid conditions and to establish predictors of survival. Background. The prognosis for patients in cardiogenic shock with severe Aortic stenosis is poor. Aortic valve replacement can be lifesaving but the presence of multiorgan failure precludes these patients from operation. Percutaneous Aortic Balloon valvuloplasty has been used in these patients with short-term improvement and could be an alternative therapeutic option. Methods. Of 310 patients undergoing percutaneous Aortic Balloon valvuloplasty, 21 were in cardiogenic shock and were included in this study. All 21 patients had associated major comorbid conditions at the time of presentation. Results. After percutaneous Aortic Balloon valvuloplasty, systolic Aortic pressure increased from 77 ± 3 (mean ± SEM) to 116 ± 8 mm Hg (p = 0.0001); Aortic valve area increased from 0.48 ± 0.04 to 0.84 ± 0.06 cm2(p = 0.0001); and cardiac index increased from 1.84 ± 0.13 to 2.24 ± 0.15 liters/min per m2(p = 0.06). Nine patients died in the hospital, two during the procedure and seven after successful percutaneous Aortic Balloon valvuloplasty (five from multiorgan failure). Five patients had vascular complications. Stroke, cholesterol emboli and Aortic regurgitation requiring Aortic valve replacement occurred in one patient each. Twelve patients (57%) survived and were followed up for 15 ± 6 months; five patients subsequently died. The Kaplan-Meier survival curve showed a 38 ± 11% survival rate at 27 months. The only predictor for longer survival rate was the postprocedure cardiac index. Conclusions. 1) Emergency percutaneous Aortic Balloon valvuloplasty can be performed successfully as a lifesaving procedure. 2) Morbidity and mortality remain high despite successful percutaneous Aortic Balloon valvuloplasty. 3) For nonsurgical candidates, percutaneous Aortic Balloon valvuloplasty may be the only therapeutic alternative.

Harit Desai – One of the best experts on this subject based on the ideXlab platform.

  • Percutaneous Aortic Balloon valvotomy in the United States: a 13-year perspective.
    The American journal of medicine, 2014
    Co-Authors: Apurva O. Badheka, Nileshkumar J. Patel, Vikas Singh, Neeraj Shah, Ankit Chothani, Kathan Mehta, Abhishek Deshmukh, Abhijit Ghatak, Ankit Rathod, Harit Desai

    Abstract:

    Abstract Background We determined the contemporary trends of percutaneous Aortic Balloon valvotomy and its outcomes using the nation’s largest hospitalization database. There has been a resurgence in the use of percutaneous Aortic Balloon valvotomy in patients at high surgical risk because of the development of less-invasive endovascular therapies. Methods This is a cross-sectional study with time trends using the Nationwide Inpatient Sample database between the years 1998 and 2010. We identified patients using the International Classification of Diseases, 9th Revision, Clinical Modification procedure code for valvotomy. Only patients aged more than 60 years with Aortic stenosis were included. Primary outcome included in-hospital mortality, and secondary outcomes included procedural complications and length of hospital stay. Results A total of 2127 percutaneous Aortic Balloon valvotomies (weighted n = 10,640) were analyzed. The use rate of percutaneous Aortic Balloon valvotomy increased by 158% from 12 percutaneous Aortic Balloon valvotomies per million elderly patients in 1998-1999 to 31 percutaneous Aortic Balloon valvotomies per million elderly patients in 2009-2010 in the United States ( P P P  = .03), unstable patient ( P P P  = .008), whereas increasing operator volume was associated with significantly reduced mortality ( P  = .03). Patients who were admitted to hospitals with the highest procedure volume and the highest volume operators had a 51% reduced likelihood ( P  = .05) of in-hospital mortality when compared with those in hospitals with the lowest procedure volume and lowest volume operators. Conclusion This study comprehensively evaluates trends for percutaneous Aortic Balloon valvotomy in the United States and demonstrates the significance of operator and hospital volume on outcomes.