title: [Aortic Valve Replacement after Balloon Valvuloplasty for Aortic Valve Stenosis in a Dialysis Patient with Cardiogenic Shock;Report of a Case].
abstract: A 67-year-old man on chronic hemodialysis was admitted with worsening congestive heart failure due to critical aortic stenosis. Echocardiography showed severe aortic stenosis with a valve area of 0.67 cm2 and an ejection fraction of 0.31. Cardiac catheterization revealed severe pulmonary hypertension with pulmonary artery pressures of 62/32 mmHg. In the middle of cardiac catheterization, the systolic pressure declined to 60 mmHg due to cardiogenic shock. Dopamine hydrochloride and dobutamine hydrochloride infusions were necessary to maintain a systolic pressure greater than 80 mmHg. Balloon aortic valvuloplasty was urgently performed. The patient's symptoms rapidly resolved except for angina on exertion. One month later, elective aortic valve replacement was performed. The postoperative course was uneventful and the he was discharged on the 60th postoperative day. A follow-up echocardiogram 6 months postoperatively revealed normal prosthetic valve function and an ejection fraction of 0.6.
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Saiseikai Central Hospital, Tokyo, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Takamatsu
authors.forename: Takashi
authors.initials: T
authors.lastname: Hirotani
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ohtsubo
authors.forename: Sumikatsu
authors.initials: S
authors.lastname: Saito
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Takeuchi
authors.forename: Tasuku
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Ayaka
authors.initials: A
authors.lastname: Endo
authors.forename: Yu
authors.initials: Y
authors.lastname: Yamasaki
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hayashida
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery*; D063126:Balloon Valvuloplasty / Q000009:adverse effects; D006328:Cardiac Catheterization / Q000009:adverse effects; D006801:Humans; D008297:Male; D006435:Renal Dialysis; D012770:Shock, Cardiogenic / Q000150:complications / Q000601:surgery*