Cardiovascular Intervention and Therapeutics

, Volume 33, Issue 2, pp 109–115 | Cite as

Predictors of early restenosis after intracardiac echocardiography guided antegrade balloon aortic valvuloplasty in high-risk or inoperable patients

  • Shinobu Hosokawa
  • Yoshikazu Hiasa
  • Akiho Seno
  • Tatuo Yasuoka
  • Tomoko Izumi
  • Riyo Ogura
Original Article
  • 75 Downloads

Abstract

Antegrade balloon aortic valvuloplasty (BAV) may be more effective than retrograde BAV. However, early restenosis is found inconstantly within three months after BAV. To evaluate the factor of ER after intracardiac echocardiogram (ICE) guided Antegrade BAV, fifty patients with severe aortic stenosis (AS) underwent BAV procedures with ICE. ER was defined as mean aortic valve pressure gradient (PG) >40 mmHg. During one-year follow-up period, 6 patients died and 2 patients underwent aortic valve replacement. ER was present in 13 patients (26%) at three months after BAV. Procedural, clinical, and hemodynamic data were collected. The mean age of the patient population was 85.4 ± 7.6 years; the mean STS score and EuroSCORE were 7.8 ± 1.1 and 14.6 ± 4.1, respectively. The mean aortic valve PG decreased from 63.4 ± 19.8 to 28.5 ± 10.1 mmHg (p < 0.0001). Baseline characteristics were similar between the two groups. There is no significant difference of mean aortic valve PG immediate after BAV(ER; 29 ± 8.8 mmHg, nonER; 21 ± 6.1 mmHg, p = ns). Univariate analysis showed patients with ER group had significantly higher rate of left ventricular hypertrophy, pulmonary hypertension, and high mean aortic valve PG at admission. Multivariate analysis revealed high mean aortic valve PG at admission as independent predictors of ER. Antegrade BAV may be effective for severe AS. Left ventricular hypertrophy, pulmonary hypertension and high mean PG were predictor of early restenosis. Early intervention should be considered for these patients.

Keywords

Aortic stenosis Antegrade balloon valvuloplasty Intracardiac echocardiography Early restenosis 

Notes

Compliance with ethical standards

This study complied with the Declaration of Helsinki in regard to investigation in humans and was approved by the institutional ethics committees at Tokushima red cross Hospital. There was no industry involvement in the design, conduct, financial support, or analysis of this study.

Conflict of interest

I have no disclosures/support grants and potential conflicts of interest.

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Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2017

Authors and Affiliations

  • Shinobu Hosokawa
    • 1
  • Yoshikazu Hiasa
    • 1
  • Akiho Seno
    • 1
  • Tatuo Yasuoka
    • 1
  • Tomoko Izumi
    • 1
  • Riyo Ogura
    • 1
  1. 1.Division of CardiologyTokushima Red Cross HospitalKomatsushimaJapan

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