Percutane transluminale ballonvalvuloplastiek bij oudere patiënten met een verworven aortaklepstenose

- The haemodynamic and clinical results of balloon valvuloplasty in ten elderly patients (73 ± 9 years) with acquired aortic stenosis are reported. After dilatation the mean systolic gradient (ΔP, mmHg) and aortic valve area (A.A., cm²) showed a significant improvement (70 ± 21 to 43 ± 12 and 0.48 ± 0. 13 to 0.74 ± 0.20, respectively). Use of a 25 mm trefoil balloon catheter in five patients resulted in additional improvement in ΔP from 53 to 46 mmHg, and in A.A. from 0.40 to 0.60 cm². During clinical follow-up (125 days to 11 months) symptomatic improvement persisted in six patients, one patient had minimal increase in exercise tolerance. while three underwent aortic valve replacement because of recurrent symptoms (after 40 days, 3 months, 1 year, respectively). Procedurerelated complications noted were: short-lasting hypotension during balloon inflation, pseudo-aneurysm of the femoral artery, emboli from valvular calcifications and from thrombus on the guidewire. In summary, aortic balloon valvuloplasty can provide an alternative, palliative treatment in high-risk elderly patients, although the potential risks should not be overlooked.