[The long-term evolution of patients with senile aortic stenosis undergoing percutaneous valve dilatation].
The long-term follow-up of 35 patients with mean age of 74.3 +/- 8 years (64-86) who underwent percutaneous aortic valvuloplasty (PAV) is presented. The mean duration of the follow-up study was 33 months (range 1-48). Global mortality was 42% (14 patients) and was related to post-PAV aortic valvular area (47% mortality in less than 0.7 cm2 area group vs 28% in greater than or equal to 0.7 cm2 group) and left ventricular ejection fraction (67% in EF less than 35% group vs 35% in EF greater than or equal to 35% group). The actuarial probability of remaining alive and free of symptoms and of cardiac surgery or new PAV was 57, 41, 33, and 20% at 1, 2, 3 and 4 years. After PAV clinical improvement was obtained in most of the patients (68%), but only 42% of those with successful dilatation remain asymptomatic after a 24 months period (85 +/- 28 mmHg, p = NS). Transvalvular gradient studied by Doppler decreased immediately after PAV (92.8 +/- 26 mmHg vs 51 +/- 16 mmHg, p less than 0.001), but returned to baseline values after 12 months. These results show that PAV yields a clinical improvement in most of the patients, but this improvement is transitory, does not modify the natural history of the disease and has a high degree of restenosis. Thus, its use must be limited to a reduced group of patients who are not candidates for cardiac surgery.
Moris
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C
Laboratorio de Hemodinámica, Hospital Central de Asturias, Universidad de Oviedo.
Martínez Trabanco
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I
Rodríguez Suárez
M L
ML
Mayordomo
J
J
Simarro
C
C
Barriales
V
V
Cortina
A
A
D000367:Age Factors; D001024:Aortic Valve Stenosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D002404:Catheterization / Q000009:adverse effects / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D005500:Follow-Up Studies; D006801:Humans; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis
Evolución a largo plazo de los pacientes con estenosis aórtica senil sometidos a dilatación valvular percutánea.