Comparison of Aortic Valve Replacement and Percutaneous Aortic Balloon Valvuloplasty for Elderly Patients With Aortic Stenosis
-
- Hashimoto Hideki
- The Division of Cardiology, Mitsui Memorial Hospital
-
- Tamura Tsutomu
- The Division of Cardiology, Mitsui Memorial Hospital
-
- Ikari Yuji
- The Division of Cardiology, Mitsui Memorial Hospital
-
- Hara Kazuhiro
- The Division of Cardiology, Mitsui Memorial Hospital
-
- Saeki Fumihiko
- The Division of Cardiology, Mitsui Memorial Hospital
-
- Isshiki Takaaki
- The Division of Cardiology, Mitsui Memorial Hospital
-
- Yamaguchi Tetsu
- The Division of Cardiology, Mitsui Memorial Hospital
-
- Wanibuchi Yasuhiko
- Cardiovascular Surgery, Mitsui Memorial Hospital
-
- Furuta Shouichi
- Cardiovascular Surgery, Mitsui Memorial Hospital
抄録
The outcome of aortic balloon valvuloplasty (ABV) was compared with that of aortic valve replacement (AVR) in aortic stenosis (AS) patients more than 60 years old. The indications for ABV included low respiratory and renal function, cancer, the patient's refusal of surgery, and low daily activity. Twenty six patients underwent AVR and 13 underwent ABV. Initially, the AVR group was younger and more symptomatic than the ABV group. Two perioperative deaths occurred in the AVR group, while there were none in the ABV group. Twenty-four AVR patients and 12 ABV patients had a successful outcome, with remarkable pressure gradient reduction in both groups. In the follow-up, only 1 death and no cardiac events were detected in the AVR group (mean follow-up of 27 months), whereas 3 deaths, 6 heart failures, 2 repeated ABV, and 4 AVR were seen in the ABV group (mean follow-up of 10 months). The data showed that ABV was safer than AVR, but a higher rate of restenosis limited its efficacy. In the ABV group, a higher ratio of balloon size to aortic diameter correlated with longer event-free survival. We concluded that for elderly AS patients, ABV should be used only in those with high surgical risk as a palliative therapy or a bridge therapy to AVR, and AVR should be primarily recommended under rigid evaluation of the patient's physical status. (Jpn Circ J 1996; 60: 142 - 148)
収録刊行物
-
- JAPANESE CIRCULATION JOURNAL
-
JAPANESE CIRCULATION JOURNAL 60 (3), 142-148, 1996
社団法人 日本循環器学会