[Valvuloplasty with balloon catheter in biologic prosthesis. Reality or illusion].
We performed catheter balloon valvuloplasty (CBV) on 8 stenotic operatively-excised bioprosthetic valves (2 Hancock and 6 Ionescu Shiley). Pathology of valves before CBV included degenerative changes: commissural fusion by mounds of calcific deposits (2 valves), fibrotic and focally calcified leaflets (7 valves) and stiff and thick valves (1 valve). Inflation of the balloon resulted in commissural splitting (2 valves), leaflet cracks and fractures (3 valves). Removal of the deflated balloon catheter was associated with debris dislodgement (3 valves). In one case the valve was unable to close with potential for acute regurgitation. Thus, CBV of bioprosthetic valves can split fused commissures by similar mechanisms as in native valves. CBV may fracture calcific deposits causing acute emboli. It can also disrupt the leaflets causing acute insufficiency. The findings suggest a limited role of CBV in the treatment of stenotic bioprosthetic valves in mitral and aortic position.
Ledesma Velasco
M
M
Hospital General del Centro Médico La Raza, Instituto Mexicano del Seguro Social, México, D.F.
Verdín Vázquez
R
R
Acosta Valdez
J L
JL
Munayer Calderón
J
J
Salgado Escobar
J L
JL
Arias Monroy
L
L
Flores Mendoza
J
J
D001705:Bioprosthesis; D002404:Catheterization; D003251:Constriction, Pathologic / Q000628:therapy; D006350:Heart Valve Prosthesis; D006801:Humans; D011475:Prosthesis Failure
Valvuloplastía con cáteter de globo en prótesis biológicas. Realidad o ilusión.