[Mid-term results of 50 percutaneous aortic valvuloplasties. Follow-up studies using Doppler echocardiography]

Abstract

The aim of this study was to assess the results of percutaneous aortic valvuloplasty in 50 patients (29 men and 21 women, mean age 74 years) at 6 months by Doppler echocardiography performed 24 hours before, 24 hours, 3 and 6 months after the procedure. The following parameters were compared: maximum instantaneous transaortic pressure gradient; mean gradient; aortic valve area and index of valve patency. The initial results of catheterisation and valvuloplasty were very satisfactory as the peak-to-peak and mean pressure gradients decreased by 50 per cent and the aortic valve area increased from 0.55 +/- 0.2 to 0.83 +/- 0.30 cm2 and the success rate defined as a final surface area greater than 0.75 cm2 was 84 per cent. Unfortunately, these favourable results were not sustained in most cases: restenosis, defined as a valve area of less than 0.7 cm2, was observed in 18 per cent of patients at Day 1 and 71 per cent of patients at the 6th month; the natural history of disease was little affected with a global mortality rate at 6 months of 18 per cent through cardiac failure and sudden death; only 18 per cent of patients maintained an aortic valve area of over 0.75 cm2 at 6 months. These results suggest that percutaneous aortic valvuloplasty should be reserved for patients in whom surgery is formally contra-indicated.