Outcomes of concomitant percutaneous coronary intervention and balloon aortic valvuloplasty. Issue 7 (24th August 2013)

• Record Type: Journal Article
• Authors: Ben‐Dor, Itsik; Maluenda, Gabriel; Looser, Patrick M.; Okubagzi, Petros; Torguson, Rebecca; Xue, Zhenyi; Lindsay, Joseph; Satler, Lowell F.; Pichard, Augusto D.; Waksman, Ron
• Is Part Of: Catheterization and cardiovascular interventions. Volume 82:Issue 7(2013:Dec. 01)
• Page Start: E835
• Page End: E841
• Publication Date: 2013-08-24
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.23193
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <p> <underline>Background:</underline> 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. <underline>Aim:</underline> To compare outcomes and complications of combined BAV and PCI with BAV alone. <underline>Methods:</underline> 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. <underline>Results:</underline> 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, <italic>P</italic> = 0.002 and 20.5 ± 10.9 vs. 12.9 ± 7.0, <italic>P</italic> < 0.001). Significantly more radiographic contrast was used in the BAV/PCI group (95.1 ± 45.5 vs. 36.7 ± 38.4 cm<sup>3</sup>, <italic>P</italic> < 0.001. Serious adverse events occurred with equal frequency 13.7 and 17.3%, <italic>P</italic> = 0.44). Transfusion requirement was also similar (21.2% vs. 20.0%, <italic>P</italic> = 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% (<italic>n</italic> = 160) during a mean follow‐up of 191 days, and in the BAV/PCI group the mortality rate was 40% (<italic>n</italic> = 32) during mean follow‐up of 175.5 day, <italic>P</italic> = 0.34. <underline>Conclusion:</underline> Combined BAV and PCI are safe and are associated with similar complications as BAV alone and may offer protection against myocardial ischemia during BAV. © 2011 Wiley Periodicals, Inc.</p> </abstract>