title: [The long-term evolution of patients with senile aortic stenosis undergoing percutaneous valve dilatation].
abstract: 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.
authors.affiliation: Laboratorio de Hemodinámica, Hospital Central de Asturias, Universidad de Oviedo.
authors.forename: C
authors.initials: C
authors.lastname: Moris
authors.forename: I
authors.initials: I
authors.lastname: Martínez Trabanco
authors.forename: M L
authors.initials: ML
authors.lastname: Rodríguez Suárez
authors.forename: J
authors.initials: J
authors.lastname: Mayordomo
authors.forename: C
authors.initials: C
authors.lastname: Simarro
authors.forename: V
authors.initials: V
authors.lastname: Barriales
authors.forename: A
authors.initials: A
authors.lastname: Cortina
mesh_terms: 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
vernacular_title: Evolución a largo plazo de los pacientes con estenosis aórtica senil sometidos a dilatación valvular percutánea.