Comparison of Procedural and In-Hospital Outcomes of Percutaneous Balloon Aortic Valvuloplasty in Patients >80 Years Versus Patients ≤80 Years

• Published in: The American journal of cardiology 2010-06, Vol.105 (12), p.1815-1820
• Main Authors: Don, Creighton W., MD, PhD, Witzke, Christian, MD, Cubeddu, Roberto J., MD, Herrero-Garibi, Jesus, MD, Pomerantsev, Eugene, MD, Caldera, Angel E., MD, McCarty, David, MD, Inglessis, Ignacio, MD, Palacios, Igor F., MD
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - mortality; Aortic Valve Stenosis - therapy; Balloon Occlusion; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiopulmonary Resuscitation - statistics & numerical data; Cardiovascular; Cardiovascular disease; Catheterization - methods; Clinical medicine; Clinical outcomes; Comparative analysis; Coronary vessels; Echocardiography; Female; Follow-Up Studies; Hospital Mortality - trends; Humans; Inpatients; Male; Massachusetts - epidemiology; Medical sciences; Medical treatment; Retrospective Studies; Treatment Outcome
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2010.01.366

Percutaneous balloon aortic valvuloplasty (PBAV) is a procedure used for palliation, bridging to surgery, and as an integral step in the procedure for percutaneous aortic valve replacement. Older patients with severe aortic stenosis are thought to have greater risk for adverse perioperative events than younger patients. The aim of this study was to evaluate the outcomes of patients aged >80 years and those aged ≤80 years who underwent PBAV to identify factors associated with adverse clinical outcomes. This was a retrospective study of 111 consecutive patients with severe symptomatic aortic stenosis who underwent retrograde PBAV at Massachusetts General Hospital from December 2004 to December 2008. Forty-nine patients (44%) were men, and the mean age for the whole group was 82 ± 8 years. Patients were divided into 2 age groups: those aged >80 years (n = 73) and those aged ≤80 years (n = 38). Procedural outcomes, complications, and in-hospital adverse events were compared. Multivariate logistic regression was used for the adjusted analysis. Nearly 90% of patients were in New York Heart Association class III or IV. Patients aged >80 years had lower baseline ejection fractions (43.5% vs 56.1%, p 80 years had less favorable preprocedural characteristics for PBAV but similar overall in-hospital clinical outcomes. Patients aged >80 years had significantly higher incidence of emergent intubation and cardiopulmonary resuscitation during PBAV.