[Transesophageal and Doppler ultrasound studies before and following percutaneous balloon valvuloplasty of the aortic valve]

Abstract

Transesophageal and Doppler-echocardiography were performed in 25 patients with severe valvular aortic stenosis before and after percutaneous balloon valvuloplasty. The maximal systolic gradient over the aortic valve determined during invasive measurements before and after valvuloplasty decreased from 71 +/- 24 mm Hg to 36 +/- 14 mm Hg; the mean systolic gradient decreased from 53 +/- 18 mm Hg to 28 +/- 10 mm Hg. The aortic orifice area increased from 0.67 +/- 0.2 to 0.94 +/- 0.2 cm2. During transesophageal echocardiography the aortic orifice area was calculated by direct planimetry. The aortic valve area increased from 0.52 +/- 0.21 cm2 before the valvuloplasty to 0.72 +/- 0.17 cm2 after intervention. After valvuloplasty small thrombotic vegetations were observed in four patients and valvular lesions in two patients. Using Doppler-echocardiographic measurements to quantify the aortic valve stenosis the maximal instantaneous gradient decreased from 94 +/- 30 before valvuloplasty to 66 +/- 25 mm Hg after valvuloplasty; the mean instantaneous gradient changed from 52 +/- 17 to 37 +/- 14 mm Hg. The aortic orifice area increased from 0.5 +/- 016 to 0.76 +/- 0.21 cm2. These results confirm that transesophageal and Doppler-echocardiography are appropriate to control the success of percutaneous balloon valvuloplasty.