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Cardiovascular Intervention and Therapeutics

, Volume 30, Issue 1, pp 45–50 | Cite as

Balloon valvuloplasty in rheumatic aortic valve stenosis: immediate and long-term results

  • Ajith Ananthakrishna PillaiEmail author
  • Chandramohan Ramasamy
  • Maheshkumar Saktheeshwaran
  • Raja Selvaraj
  • Santhosh Satheesh
  • Balachander Jayaraman
Original Article

Abstract

To study the immediate and long-term results of balloon aortic valvuloplasty (BAV) in a large cohort of patients with rheumatic valvular aortic stenosis. Single tertiary care center retrospective data analysis of immediate and long-term outcomes in patients following BAV from 2000 to 2008. Ninety-two patients with rheumatic aortic stenosis (AS) were studied who underwent BAV. Mean age of patients was 21.7 years (95 % CI 14.3–28.9) with mean follow-up period of 5.7 years (±SD 1.3). Intervention resulted in successful BAV (more than 50 % reduction in baseline gradient) in 79 (85.9 %) subjects (Group A) and partially successful BPV (<50 % reduction in baseline gradient) in 8 (8.7 %) subjects (Group B). BAV failed in 5 (5.4 %) subjects (Group C). Concomitant balloon mitral valvuloplasty was done in 23/92 cases. Mean left ventricular systolic pressure decreased from 165.6 (95 % CI 142.7–196.3) to 110.9 mmHg (95 % CI 92.1–129.6), (P < 0.001) and mean aortic valve (AV) gradient from 50.7 (95 % CI 35.12–66.22) to 27.2 mmHg (95 % CI 25.83–31.23), (P < 0.001). The mean change in ejection fraction and mean AV gradient were significantly different between success (Groups A and B) and failure groups (P < 0.001). Different grades of aortic regurgitation were noted in 32 (34.78 %) patients post BAV (severe regurgitation in 2.18 %). Anova post hoc analysis showed sustained gradient reductions at 1- and 5-year follow-up (P > 0.05). The need for surgery was much lower in Group A (2.5 %) compared to Group B (50 %) and C (100 %). BAV is an effective treatment strategy in dominant AS in multi valvular rheumatic disease situations. Combined aortic and mitral valvuloplasty was performed in one-fourth of study patients.

Keywords

Balloon aortic valvuloplasty Rheumatic heart disease Multivalve stenosis Combined valvuloplasty Commissural splitting 

Notes

Acknowledgments

None.

Conflict of interest

None.

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Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2014

Authors and Affiliations

  • Ajith Ananthakrishna Pillai
    • 1
    Email author
  • Chandramohan Ramasamy
    • 1
  • Maheshkumar Saktheeshwaran
    • 1
  • Raja Selvaraj
    • 1
  • Santhosh Satheesh
    • 1
  • Balachander Jayaraman
    • 1
  1. 1.Department of CardiologyJawaharlal Institute of Post Graduate Medical Education and ResearchPondicherryIndia

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