Doppler evaluation of results of percutaneous aortic balloon valvuloplasty in calcific aortic stenosis

To evaluate the short-term results of percutaneous aortic balloon valvuloplasty, 55 consecutive elderly patients with symptomatic, severe aortic stenosis who were at high risk for surgical intervention underwent the procedure, with follow-up by clinical evaluation and Doppler echocardiography. Over a mean follow-up of 6.2 months, there were three early deaths (<30 days) and eight late deaths. Nine patients underwent subsequent aortic valve surgery, and four had repeat balloon valvuloplasty. Doppler echocardiography revealed a reduction in aortic valve mean gradient from 48 ± 18 to 33 ± 12 mm Hg after the procedure (p < 0.0001) but a return to 46 ± 16 mm Hg at follow-up (p < 0.05). The aortic valve area increased from 0.54 ± 0.15 to 0.85 ± 0.23 cm² after the procedure (p < 0.0001), but there was a significant decrease to 0.67 ± 0.19 cm² at follow-up (p < 0.05). Of patients free of aortic valve operation or death after 30 days after the procedure, 76% were severely symptomatic before the procedure as compared with 38% at follow-up. In patients undergoing percutaneous aortic balloon valvuloplasty, there is a continued high short-term mortality and a significant incidence of restenosis over short-term follow-up. Nontheless, a subset of patients do experience sustained clinical improvement from this procedure.