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Two-Year-Survival Rate of High-Risk Elderly Patients With Severe Aortic Stenosis Treated With Perfusion-Balloon Valvuloplasty Without Rapid Pacing

2023; Elsevier BV; Volume: 209; Linguagem: Inglês

10.1016/j.amjcard.2023.09.059

1879-1913

Giancarla Scalone, Alessandro Aimi, Filippo Bruscoli, Mariateresa Ciommi, Federico Di Giusto, Luca Di Vito, Luca Mariani, Simona Silenzi, Pierfrancesco Grossi,

Aortic Disease and Treatment Approaches

Aortic stenosis (AS) represents the most common primary valve disease leading to surgery or catheter intervention in Europe and North America, with an increasing prevalence due to the aging population. 1 Eveborn GW Schirmer H Heggelund G Lunde P Rasmussen K. The evolving epidemiology of valvular aortic stenosis. The Tronso study. Heart. 2013; 99: 396-400 Crossref PubMed Scopus (413) Google Scholar Transcatheter aortic valve replacement (TAVR) has been shown to be superior in terms of mortality to medical therapy in extreme-risk patients and noninferior or superior to surgery in high-risk patients. 2 Adams DH Popma JJ Reardon MJ Yakubov SJ Coselli JS Deeb GM Gleason TG Buchbinder M Hermiller Jr, J Kleiman NS Chetcuti S Heiser J Merhi W Zorn G Tadros P Robinson N Petrossian G Hughes GC Harrison JK Conte J Maini B Mumtaz M Chenoweth S Oh JK U.S. CoreValve Clinical InvestigatorsTranscatheter aortic-valve replacement with a self-expanding prosthesis. N Engl J Med. 2014; 370: 1790-1798 Crossref PubMed Scopus (2196) Google Scholar ,3 Baumgartner H Falk V Bax JJ De Bonis M Hamm C Holm PJ Iung B Lancellotti P Lansac E Rodriguez Muñoz D Rosenhek R Sjögren J Tornos Mas P Vahanian A Walther T Wendler O Windecker S Zamorano JL ESC Scientific Document Group2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017; 38: 2739-2791 Crossref PubMed Scopus (2) Google Scholar The percutaneous balloon aortic valvuloplasty (BAV) is actually recommended by the European Society of Cardiology guidelines as a bridge to surgery or TAVR or as a diagnostic means in patients with severe AS and particular clinical settings. 3 Baumgartner H Falk V Bax JJ De Bonis M Hamm C Holm PJ Iung B Lancellotti P Lansac E Rodriguez Muñoz D Rosenhek R Sjögren J Tornos Mas P Vahanian A Walther T Wendler O Windecker S Zamorano JL ESC Scientific Document Group2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017; 38: 2739-2791 Crossref PubMed Scopus (2) Google Scholar ,4 Debry N Kone P Vincent F Lemesle G Delhaye C Schurtz G Spillemaeker H Porouchani S Coisne A Auffray JL Sudre A Lamblin N Bonello L Van Belle E. Urgent balloon aortic valvuloplasty in patients with cardiogenic shock related to severe aortic stenosis: time matters. EuroIntervention. 2018; 14: e519-e525 Crossref PubMed Scopus (36) Google Scholar Nonocclusive Balloon Aortic Valvuloplasty in High-Risk Elderly Patients With Severe Aortic StenosisAmerican Journal of CardiologyVol. 209PreviewValvular heart disease (VHD), including aortic stenosis (AS), stands as a prominent contributor to cardiovascular morbidity and mortality worldwide. The incidence of calcific AS is on the increase because of the aging population, particularly affecting older adults in developed countries. This condition is associated with high mortality rates, especially in those with low left ventricular ejection fraction or symptomatic patients.1 In Japan, where total cholesterol levels and the use of anti-hypertensive medications have both increased over the past half-century,2 the proportion of elderly is high and continues to grow. Full-Text PDF