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首页> 外文期刊>The American Journal of Cardiology >Effectiveness of Rescue Percutaneous Balloon Aortic Valvuloplasty in Patients With Severe Aortic Stenosis and Acute Heart Failure
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Effectiveness of Rescue Percutaneous Balloon Aortic Valvuloplasty in Patients With Severe Aortic Stenosis and Acute Heart Failure

机译：恢复经皮气囊主动脉术对严重主动脉狭窄和急性心脏衰竭患者的有效性

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The prognosis of patients with cardiogenic shock (CS) or refractory pulmonary edema because of severe aortic stenosis remains poor. The purpose of this study was to assess the outcomes of rescue percutaneous balloon aortic valvuloplasty (PBAV) in the transcatheter aortic valve implantation (TAVI) era. Patients were consecutively included between 2008 and 2016. CS was defined as = 1 sign of systemic hypoperfusion and need of catecholamines. Refractory pulmonary edema was defined as not controlled by optimal medical treatment. A total of 40 patients, 22 men (55%), aged 79 +/- 9 years, were included: 17 with CS (42.5%), 23 with refractory pulmonary edema (57.5%). After PBAV, mean transaortic gradient decreased from 47 +/- 16 mm Hg to 32 +/- 10 nun Hg (p 0.001), aortic valve area increased from 0.60 +/- 0.18 cm(2) to 0.88 +/- 0.22 cm(2) (p 0.0001), left ventricular ejection fraction increased from 35 +/- 15 to 37 +/- 14% (p = 0.02), and systolic pulmonary artery pressure decreased from 61 +/- 15 to 48 +/- 12 mm Hg (p = 0.002). There was no procedural death. Early death occurred in 12 patients (30%). After PBAV, 16 of the 28 survivors (57%) were bridged to surgical aortic valve replacement (SAVR; n = 7) or TAVI (n = 9), and 12 (43%) were denied definitive therapy. The 2-year estimated survival rate was 71 +/- 17% after SAVR, 36 +/- 19% after TAVI, and 8 8% after PBAV alone. In conclusion, rescue PBAV is safe in patients with CS and high-risk aortic stenosis or refractory pulmonary edema and may improve their dismal prognosis when followed by TAVI or SAVR. (C) 2017 Elsevier Inc. All rights reserved.
机译：由于严重主动脉狭窄，患有心形成休克（CS）或难治性肺水肿的患者的预后仍然差。本研究的目的是评估经截面主动脉瓣植入（Tavi）时代的救援经皮球囊主动脉瓣膜成形术（PBAV）的结果。患者在2008和2016年间连续纳入.CS被定义为＆ = 1次符号的全身低血量卷积和需求的儿茶酚胺。耐火性肺水肿定义为不受最佳医疗的不控制。共有40名患者，22名男性（55％），均为79 +/- 9岁：17例，Cs（42.5％），23例，耐火性肺水肿（57.5％）。在PBAV之后，平均转子梯度从47 +/-16mm Hg降至32 +/- 10 nun hg（p <0.001），主动脉瓣面积从0.60 +/- 0.18cm（2）增加到0.88 +/- 0.22 Cm（2）（P <0.0001），左心室喷射馏分从35 +/-15增加到37 +/- 14％（P = 0.02），并且收缩动脉压力从61 +/- 15到48 +降低/ - 12 mm hg（p = 0.002）。没有程序死亡。早期死亡发生在12名患者（30％）。在PBAV后，28个幸存者中的16个（57％）桥接到外科主动脉瓣膜置换（SAVR; n = 7）或Tavi（n = 9），12（43％）被拒绝确定的疗法。在萨维尔后，2年估计的存活率为71 +/- 17％，在Tavi之后36 +/- 19％，仅在PBAV后8％8％。总之，救援PBAV对CS和高风险性狭窄或难治性肺水肿的患者安全，并且可以在Tavi或Savr之后改善其令人沮丧的预后。 （c）2017年Elsevier Inc.保留所有权利。

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