title: Immediate results and long-term follow-up after repeat balloon aortic valvuloplasty.
abstract: Balloon aortic valvuloplasty (BAV) was performed in 219 elderly patients with aortic stenosis between December 1985 and April 1990. Forty-three patients underwent repeat BAV for symptomatic restenosis of the aortic valve 13 +/- 8 mo following initial BAV. To evaluate the outcome following initial and repeat BAV, hemodynamic results were analyzed according to the following subgroups: BAV 1--initial BAV for all patients (n = 219); BAV 1/1--initial BAV in those who had only one BAV (n = 176); BAV 1/2--the initial BAV in those who had repeat BAV (n = 43); and BAV 2--repeat BAV (n = 43). The mean age of patients undergoing BAV 2 was 82 +/- 6 yr compared to 78 +/- 10 yr for all patients undergoing BAV 1 (p = .01). At the time of BAV 1 there was no difference in baseline or post-valvuloplasty aortic valve area (AVA) or peak aortic valve gradient (AVG) for patients having BAV 1/1 compared to those having BAV 1/2. However, for patients having repeat BAV, although the magnitude of the hemodynamic improvement of BAV 1/2 (AVA increased from 0.6 to 0.9 cm2, AVG decreased from 68 to 34 mm Hg, p less than .001) was similar to the magnitude of the hemodynamic improvement of BAV 2 (AVA increased from 0.5 to 0.8 cm2, AVG decreased from 65 to 34 mm Hg, p less than .001), the baseline AVA (0.5 cm2 at BAV 2 vs. 0.6 at BAV 1/2) and the post-valvuloplasty AVA (0.8 cm2 at BAV 2 vs. 0.9 at BAV 1/2) were significantly smaller (p less than .004).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Charles A. Dana Research Institute, Beth Israel Hospital, Boston.
authors.forename: R E
authors.initials: RE
authors.lastname: Kuntz
authors.forename: A N
authors.initials: AN
authors.lastname: Tosteson
authors.forename: L A
authors.initials: LA
authors.lastname: Maitland
authors.forename: P
authors.initials: P
authors.lastname: Gordon
authors.forename: B M
authors.initials: BM
authors.lastname: Leonard
authors.forename: R G
authors.initials: RG
authors.lastname: McKay
authors.forename: A D
authors.initials: AD
authors.lastname: Berman
authors.forename: D J
authors.initials: DJ
authors.lastname: Diver
authors.forename: R D
authors.initials: RD
authors.lastname: Safian
mesh_terms: D000206:Actuarial Analysis; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D002404:Catheterization; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D012008:Recurrence; D015996:Survival Rate