title: [Aortic valve replacement after percutaneous transcatheter aortic valvuloplasty for severe aortic stenosis].
abstract: BACKGROUND
  Aortic valve replacement( AVR) is a definitive treatment in patients with severely calcified aortic stenosis (AS). However, elderly patients with multiple comorbidities are considered to be unsuitable for AVR. Percutaneous transcatheter aortic valvuloplasty( PTAV) has been performed as a palliative option to relieve symptoms or to be a bridge use toward definitive therapy. This study aimed to examine the effectiveness and clinical outcome of surgical AVR subsequent to PTAV.
  
  
  METHODS
  Since 2010, 5 symptomatic patients have undergone AVR after PTAV in our institution. PTAV was performed as a bridge to definitive AVR in 2 patients. Other 2 patients developed symptomatic aortic valve restenosis during a follow-up, and required AVR. In the last patient,AVR was carried out after successful noncardiac surgery subsequent to PTAV.
  
  
  RESULTS
  AVR improved cardiac hemodynamics in all patients. There was no operative death. Postoperative course was uneventful and all patients were discharged on foot except for 1 patient in whom metastatic liver tumor from advanced gastric cancer was noted.
  
  
  CONCLUSIONS
  AVR might be performed safely even in high-risk patients with the history of PTAV. PTAV is useful as a palliation or a bridge to definitive therapy for treatment of patients with severe AS unsuitable for surgery.
authors.affiliation: econd Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Uchida
authors.forename: Cholsu
authors.initials: C
authors.lastname: Kim
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Maekawa
authors.forename: Ryota
authors.initials: R
authors.lastname: Miyazaki
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kuroda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mizumoto
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yoshimura
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Sadahiro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D063126:Balloon Valvuloplasty; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence