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Catheter Cardiovasc Interv. 2013 Dec 1;82(7):E835-41. doi: 10.1002/ccd.23193. Epub 2013 Aug 24.

Outcomes of concomitant percutaneous coronary intervention and balloon aortic valvuloplasty.

Author information

1
Division of Cardiology, Washington Hospital Center, Washington, DC.

Abstract

BACKGROUND:

Coronary artery disease often coexists with severe aortic stenosis. The feasibility and safety of combined balloon aortic valvuloplasty (BAV) and percutaneous coronary intervention (PCI) are unknown.

AIM:

To compare outcomes and complications of combined BAV and PCI with BAV alone.

METHODS:

The study cohort consisted of 409 patients with severe aortic stenosis undergoing BAV from 1/2007 to 12/2010. Overall, 329 patients underwent BAV alone and 80 underwent concomitant PCI. Clinical and hemodynamic data, as well as acute and intermediate-term outcomes, were collected.

RESULTS:

At the operator's discretion PCI was done before BAV in 66 (82.5%) and after in 14 (17.5%). Patients who underwent concomitant procedures had a higher incidence of prior stroke and a lower incidence of atrial fibrillation. Procedure time and fluoroscopic time were significantly greater in the BAV/PCI group, (90.0 ± 36.6 vs. 72.8 ± 39.8, P = 0.002 and 20.5 ± 10.9 vs. 12.9 ± 7.0, P < 0.001). Significantly more radiographic contrast was used in the BAV/PCI group (95.1 ± 45.5 vs. 36.7 ± 38.4 cm(3) , P < 0.001. Serious adverse events occurred with equal frequency 13.7 and 17.3%, P = 0.44). Transfusion requirement was also similar (21.2% vs. 20.0%, P = 0.81). The frequency of a periprocedural increase in troponin or creatinine was also similar. In the BAV alone group the mortality rate was 48.6% (n = 160) during a mean follow-up of 191 days, and in the BAV/PCI group the mortality rate was 40% (n = 32) during mean follow-up of 175.5 day, P = 0.34.

CONCLUSION:

Combined BAV and PCI are safe and are associated with similar complications as BAV alone and may offer protection against myocardial ischemia during BAV.

KEYWORDS:

aortic stenosis; percutaneous coronary intervention; valvuloplasty

PMID:
21735514
DOI:
10.1002/ccd.23193
[Indexed for MEDLINE]

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