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Brain & Heart Balloon valvuloplasty for aortic stenosis

Figure 17. The role of repeat balloon aortic valvuloplasty (BAV) in two
different patients. In both patients, peak aortic valve gradients fell after
the first BAV (1stB), but at follow-up (FU), the gradient rose. On repeat
Figure 15. Graph illustrating the results of balloon aortic valvuloplasty BAV (2ndB), the pressure gradients decreased and stayed low at 6-year
(BAV) based on outcomes. In the favorable outcomes group (Group I), (6Yr) FU by Doppler (D) assessment. Note: Pre: Before BAV. Reproduced
the aortic valve peak gradients fell (p < 0.001) immediately (IMM) from Rao et al. 65
after BAV and remained low (p > 0.1) at follow-up (FU) (left panel).
In the poor results group (Group II), the aortic valve peak gradients
fell (p < 0.01) immediately after BAV but increased (p < 0.01) at FU
(right panel). Mean ± standard error of the mean (SEM) is indicated.
Reproduced from Rao. 20

Figure 18. Diagram displaying the magnitude of aortic insufficiency
(AI) evaluated in Doppler studies before (Pre), the day following (Post)
balloon aortic valvuloplasty (BAV), and at long-term follow-up (FU). An
increase (p = 0.002) in AI from pre-BAV to post-BAV was observed. At
Figure 16. Chart illustrating the role of the number of risk factors on the late FU, the AI increased further, with grade 3+ AI identified in seven out
frequency of restenosis following balloon aortic valvuloplasty. The higher of 26 patients (p < 0.02). Reproduced from Galal et al. 19
the number of risk factors, the greater the likelihood of re-obstruction
(p = 0.01). The actual number of patients and percentages are displayed
on the cap of each bar. Reproduced from Rao. 11 beneficial in relieving AVS in fetuses, 78-92 full-term 93-97 ,
and premature 98-104 neonates, as well as in adolescents and
105
quantitated post-BAV AI predicts the late onset of AI young adults. These age groups are not discussed further
(Figure 20). Large B/A ratios were thought to be producing here, and interested readers may review the data in the
AI both in animal models and clinical cases. 76,77 Therefore, cited references. In the elderly with calcific AVS, BAV was
76
we plotted the relationship between the level of AI at initially considered a useful technique. 10,106-109 However,
long-term and B/A ratios (Figure 21) and were unable to subsequent evaluations revealed that BAV provides only
demonstrate a positive relationship. 19 temporary relief for calcific AVS in the elderly. 110,111 As a
result, BAV is no longer recommended for this age group.
6. Aortic stenosis in other age groups Instead, the replacement of the aortic valve through
112
The preceding sections provide an overview of the transcatheter methodology has become the procedure of
outcomes of BAV in children. BAV has also been proven choice. 112-114

Volume 2 Issue 3 (2024) 6 doi: 10.36922/bh.2914