Balloon aortic valvuloplasty in elderly patients at high risk for surgery, or inoperable: Immediate and mid-term results

Although aortic valve replacement is undoubtedly the treatmentof choice for aortic valve stenosis, balloon aortic valvuloplastymay represent the only possible treatment for some frail elderlypatients who may have additional medical problems. We evaluatedimmediate and 1-year results of balloon aortic valvuloplastyin 86 patients 80 years with severe aortic stenosis. Mean agewas 84±3 years. Forty-four % were 85 years or older.Mean gradient decreased from 68 to 26 mmHg and valve area increasedfrom 0•53 to 0•96 cm² (P<0•05). There weretwo per-procedural deaths. No local vascular complication wasobserved During the follow-up (13±9 months), 27 patientsdied, four had repeat balloon aortic valvuloplasty and eightunderwent aortic valve replacement. Persistent clinical improvementwas observed in 78% of the surviving patients. One-year actuarialsurvival rate was 73%. Balloon aortic valvuloplasty appearsto be a safe and valuable technique in cases where surgery cannotbe performed or carries a very high risk.