title: Acute and long-term outcomes of percutaneous balloon aortic valvuloplasty for the treatment of severe aortic stenosis.
abstract: OBJECTIVE
  This study aimed to evaluate the indications, short- and long-term outcomes of balloon aortic valvuloplasty (BAV) in patients with severe aortic stenosis (AS).
  
  
  METHODS
  A cohort of 112 patients with AS underwent 114 BAV procedures between October 2012 and July 2015 in two Polish interventional cardiology centers. Clinical and echocardiographic data were prospectively collected within 1, 6, and 12 months follow-up.
  
  
  RESULTS
  BAV was performed as a bridge to TAVI (51.8%), surgical aortic valve replacement (AVR, 5.4%), before urgent noncardiac surgery (8.0%), for symptom relief (33.0%) and cardiogenic shock (1.8%). Periprocedural, in-hospital, 1-, 6-, 12-month mortality were 2.7%; 8.9%; 8.9%; 16.9%; 22.3%, respectively. Serious periprocedural adverse events occurred in 18.8% of patients. After the procedure, mean aortic valve area (AVA) increased from 0.59 ± 0.18 to 0.82 ± 0.24 cm2, mean peak aortic valve gradient (pAVG) decreased from 94.0 ± 27.6 to 65.4 ± 20.0 mm Hg, mean aortic gradient decreased from 58.0 ± 17.8 to 40.5 ± 14.6 mm Hg, P < 0.05 for all. Left ventricular ejection fraction (LVEF) increased from median (interquartile range) of 53.5 (30 - 64) to 60 (45 - 65)% after 1 month (P < 0.05). In patients with impaired left ventricle function (LVEF <40%), LVEF significantly improved (median increase of 16%) after 1 and 6 months (P < 0.05). At 12 months patients had higher AVA, pAVG, and LVEF as compared to baseline (P < 0.05).
  
  
  CONCLUSIONS
  BAV is a useful procedure in high-risk AS patients, where achieved effects can be sufficient in bridging patients for TAVI/AVR. © 2016 Wiley Periodicals, Inc.
authors: Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, University Hospital, Krakow, Poland.
authors: Marzena
authors: M
authors: Daniec
authors: Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, the John Paul II Hospital, Krakow, Poland.
authors: Bartłomiej
authors: B
authors: Nawrotek
authors: Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, University Hospital, Krakow, Poland.
authors: Danuta
authors: D
authors: Sorysz
authors: Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, University Hospital, Krakow, Poland.
authors: Tomasz
authors: T
authors: Rakowski
authors: Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, University Hospital, Krakow, Poland.
authors: Artur
authors: A
authors: Dziewierz
authors: Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, University Hospital, Krakow, Poland.
authors: Łukasz
authors: Ł
authors: Rzeszutko
authors: Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, University Hospital, Krakow, Poland.
authors: Paweł
authors: P
authors: Kleczyński
authors: Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, the John Paul II Hospital, Krakow, Poland.
authors: Jarosław
authors: J
authors: Trębacz
authors: Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, the John Paul II Hospital, Krakow, Poland.
authors: Marek
authors: M
authors: Tomala
authors: Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, the John Paul II Hospital, Krakow, Poland.
authors: Krzysztof
authors: K
authors: Żmudka
authors: Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, University Hospital, Krakow, Poland.|Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, the John Paul II Hospital, Krakow, Poland.
authors: Dariusz
authors: D
authors: Dudek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D063126:Balloon Valvuloplasty / Q000009:adverse effects / Q000401:mortality; D004452:Echocardiography; D005260:Female; D006439:Hemodynamics; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D011044:Poland; D011446:Prospective Studies; D020127:Recovery of Function; D012042:Registries; D012720:Severity of Illness Index; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
keywords: aortic stenosis; balloon aortic valvuloplasty; surgical aortic valve replacement; transcatheter aortic valve implantation