RESULTS OF BALLOON AORTIC VALVULOPLASTY IN PATIENTS WITH AORTIC-STENOSIS ASSOCIATED WITH SIGNIFICANT AORTIC REGURGITATION

The influence of balloon aortic valvuloplasty (BA V) on aortic regurgi tation (AR) in patients with severe aortic stenosis associated with gr eater-than-or-equal-to grade II AR was studied by supraaortic angiogra m before and after BA V. The results of 50 patients aged 72 +/- 12 yea rs with significant AR before BA V (group A) were compared to 297 pati ents (mean age 76 +/- 10 years) with no or mild AR (group B). In group A, the patients had a higher left ventricular end diastolic volume (9 6 +/- 19 mL/m2 vs 81 +/- 32 mL/m2, P < 0.01) and left ventricular end diastolic pressure (23 +/- 9 mmHg vs 19 +/- 9 mmHg, P < 0.01). The aor tic valve area was similar in both groups. Following BAV, the improvem ent in aortic valve area and hemodynamics were similar in both groups. In group A, AR remained unchanged in 31 patients (62%), increased by 1 grade in 13 patients (26%), and decreased by 1 grade in 6 patients ( 12%). In group B, AR increased by > 1 grade in 34 patients (11%) and > 2 grades in 4 patients (1.3%) post-BAV. Two patients in group B under went emergency aortic valve replacement following BA V because of seve re acute AR. In conclusion, when it is indicated, BAV can be performed with similar risk in patients with significant AR.