title: Dual balloon technique for valvuloplasty of aortic stenosis in adults.
abstract: A dual balloon technique was studied in 16 patients with aortic stenosis in whom results with a single balloon (up to 20 mm, 5.5 cm or 25 mm, 3.0 cm in diameter and length, respectively) were judged to be suboptimal. Dual balloon valvuloplasty was performed using 2 balloons advanced and inflated simultaneously across the stenotic aortic valve orifice. For the group as a whole, the average peak transvalvular gradient was reduced from 79 +/- 8 to 57 +/- 7 mm Hg (mean +/- standard error) using a single balloon (p less than 0.0005), and reduced further to 36 +/- 4 mm Hg using dual balloons (p less than 0.0005 compared with single balloon results). Similarly, calculated aortic valve orifice area was increased from 0.45 +/- 0.04 to 0.57 +/- 0.05 cm2 using a single balloon (p less than 0.0005), and further increased to 0.77 +/- 0.06 cm2 using dual balloons (p less than 0.0005). Dual balloon dilation caused no complications directly attributable to the use of 2 balloons, including no exacerbation of aortic regurgitation. These results suggest that dual balloon valvuloplasty is safe and efficacious in selected patients with aortic stenosis.
authors.affiliation: Department of Medicine, New England Medical Center/Tufts University School of Medicine, Boston, Massachusetts 02111.
authors.forename: J M
authors.initials: JM
authors.lastname: Isner
authors.forename: D N
authors.initials: DN
authors.lastname: Salem
authors.forename: M R
authors.initials: MR
authors.lastname: Desnoyers
authors.forename: C D
authors.initials: CD
authors.lastname: Fields
authors.forename: K R
authors.initials: KR
authors.lastname: Halaburka
authors.forename: G A
authors.initials: GA
authors.lastname: Slovenkai
authors.forename: T J
authors.initials: TJ
authors.lastname: Hougen
authors.forename: E J
authors.initials: EJ
authors.lastname: Eichhorn
authors.forename: K
authors.initials: K
authors.lastname: Rosenfield
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000503:physiopathology; D001022:Aortic Valve Insufficiency / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000628:therapy*; D002302:Cardiac Output; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011312:Pressure; D012008:Recurrence