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Objectives: To determine outcomes following balloon aortic valvuloplasty (BAV) in aortic stenosis (AS) patients with a left ventricular ejection fraction (LVEF) <20%. Background: Severe AS patients with a LVEF <20% are excluded from United States (U.S.) transcatheter aortic valve replacement (TAVR) trials and often surgical aortic valve replacement (AVR). The role for BAV to enhance LVEF is unclear. Methods: Our BAV database of 270 consecutive patients extending from 2005 through 2010 was queried for a preoperative LVEF <20%. Demographics, echocardiograms, procedural technique, and outcomes were analyzed. Pre-and postoperative echocardiograms were used to determine improvement in aortic valve area (AVA) and LVEF. Results: Sixteen patients were identified with a median age of 82 years. The composite Society of Thoracic Surgeons' (STS) mortality risk was 16.4%. The median preoperative AVA and LVEF were 0.60 cm 2 and 16%, respectively, and postoperative AVA and LVEF were 0.77 cm 2 and LVEF 19%, respectively. About 15 of the 16 patients had postoperative echocardiograms available for comparison. And 7 of these 15 (47%) demonstrated improvement in LVEF to !20% (median LVEF 25%). The absence of coronary disease and improvement in AVA of !0.2 cm 2 was associated with postoperative LVEF of !20%. Procedural mortality was 0%. The 30-day, 6-month, and 1-year survival was 69%, 56%, and 29%. STS's mortality risk score !15% was associated with short-term mortality. Conclusion: With appropriate technique, BAV can be reasonably safe in patients with LVEF <20%. Roughly half of these patients demonstrated improvement in LVEF to !20%. V C 2013 Wiley Periodicals, Inc.

Graduate Studies The Vault: Electronic Theses and Dissertations 2012-09-13 A modified fingerprinting technique for an indoor, range-free, localization system with dynamic radio map annealing over time Lesser, Andrew M. Lesser, A. M. (2012). A modified fingerprinting technique for an indoor, range-free, localization system with dynamic radio map annealing over time (Unpublished master's thesis).

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