Aortic stenosis valvuloplasty
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Mohammed A. Sbeih, M.D. [2]
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Aortic Stenosis Microchapters |
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Diagnosis |
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Treatment |
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Percutaneous Aortic Balloon Valvotomy (PABV) or Aortic Valvuloplasty |
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Transcatheter Aortic Valve Replacement (TAVR) |
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Case Studies |
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Aortic stenosis valvuloplasty On the Web |
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American Roentgen Ray Society Images of Aortic stenosis valvuloplasty |
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Directions to Hospitals Treating Aortic stenosis valvuloplasty |
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Risk calculators and risk factors for Aortic stenosis valvuloplasty |
Overview
Aortic valve replacement procedure is the mainstay of treatment of aortic stenosis as it improves both symptoms and life expectancy. Minimally invasive methods of treatments such as percutaneous aortic balloon valvotomy (PABV) maybe the best alternative for surgery in patients whom have severe comorbidities and whom considered to have a highest risk surgery. Transcatheter aortic valve implantation is another good alternative as well, although both have their own limitations.
Indications
ACC/AHA guidelines concluded that percutaneous aortic balloon valvotomy (PABV) is not a substitute for valve replacement in adults in all cases. although there are some exceptions. ACC/AHA guidelines below for percutaneous aortic balloon valvotomy (PABV) indicate the presence of two settings in which such procedure could be done. Some studies showed that this method is preferable to surgery in children and young adults with congenital, noncalcific AS. Adults with severe calcific AS are not good candidates for this procedure as there is high restenosis rate and high risk of complications.
ACC/AHA Guidelines- Indications for Percutaneous Aortic Balloon Valvotomy (DO NOT EDIT) [1]
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Class IIb1. Aortic balloon valvotomy might be reasonable as a bridge to surgery in hemodynamically unstable adult patients with AS who are at high risk for AVR. (Level of Evidence: C) 2. Aortic balloon valvotomy might be reasonable for palliation in adult patients with AS in whom AVR cannot be performed because of serious comorbid conditions. (Level of Evidence: C) Class III1. Aortic balloon valvotomy is not recommended as an alternative to AVR in adult patients with AS; certain younger adults without valve calcification may be an exception. (Level of Evidence: B) |
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Percutaneous Aortic Balloon Valvotomy (PMBV) Technique
Outcome
Sources
- 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease [1].
References
- ↑ 1.0 1.1 Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD; et al. (2008). "2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (13): e1–142. doi:10.1016/j.jacc.2008.05.007. PMID 18848134.