Background: Balloon aortic valvuloplasty (BAV) might be a life saving procedure in critically advanced aortic stenosis (AS) as a bridge therapy to surgical aortic valve replacement (AVR) or to trans-catheter aortic heart valve (TAVI), by reducing trans-aortic gradient and increasing aortic valve area (AVA). Few is known on the benefit of BAV on cardiac output. Our study proposed to evaluate the hemodynamic changes after BAV by transthoracic echocardiography (TTE). Methods: 30 consecutive patients with AS undergoing BAV were prospectively included between July 2014 and July 2015. Hemodynamic assessment was performed pre-and post-BAV by TTE. Low cardiac output (CO) was defined by a cardiac index (CI) < 2.5 L/min/m 2 .Results: Mean age was 82 ± 8 years; 56.7% were female; mean logistic EuroSCORE I was 31 ± 19 %. 20 patients (67%) had low CO. TTE showed that the patients with low CO improved AVA (from 0.57 ± 0.2 to 1.05 ± 0.5, p=0.043), CI (from 1.9 ± 0.4 to 2.8 ± 1.0 L/min/m 2 , p<0.0001), LVEF (from 31 ± 16 to 38 ± 13%, p=0.006), tend to decrease systolic pulmonary artery pressure (sPAP) (from 52 ± 19 to 43 ± 11 mmHg, p=0.06) and to increase mean arterial pressure (MAP) (from 79 ± 10 to 83 ± 12 mmHg, p=0.046). There was no statistically significant difference in terms of hemodynamic in patients with a normal CO (CI ≥ 2.5 L/min/m 2 ).
Conclusion:By increasing AVA, BAV significantly and immediately improve cardiac output especially in patients with low CO at baseline.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.