Balloon aortic valvuloplasty for severe aortic stenosis as rescue or bridge therapy

2021
journal article
article
21
cris.lastimport.wos2024-04-09T23:44:39Z
dc.abstract.enThe study aimed to assess procedural complications, patient flow and clinical outcomes after balloon aortic valvuloplasty (BAV) as rescue or bridge therapy, based on data from our registry. A total of 382 BAVs in 374 patients was performed. The main primary indication for BAV was a bridge for TAVI (n = 185, 49.4%). Other indications included a bridge for AVR (n = 26, 6.9%) and rescue procedure in hemodynamically unstable patients (n = 139, 37.2%). The mortality rate at 30 days, 6 and 12 months was 10.4%, 21.6%, 28.3%, respectively. In rescue patients, the death rate raised to 66.9% at 12 months. A significant improvement in symptoms was confirmed after BAV, after 30 days, 6 months, and in survivors after 1 year (p < 0.05 for all). Independent predictors of 12-month mortality were baseline STS score [HR (95% CI) 1.42 (1.34 to 2.88), p < 0.0001], baseline LVEF <20% [HR (95% CI) 1.89 (1.55–2.83), p < 0.0001] and LVEF <30% at 1 month [HR (95% CI) 1.97 (1.62–3.67), p < 0.0001] adjusted for age/gender. In everyday clinical practice in the TAVI era, there are still clinical indications to BAV a standalone procedure as a bridge to surgery, TAVI or for urgent high risk non-cardiac surgical procedures. Patients may improve clinically after BAV with LV function recovery, allowing to perform final therapy, within limited time window, for severe AS which ameliorates long-term outcomes. On the other hand, in patients for whom an isolated BAV becomes a destination therapy, prognosis is extremely poor.
dc.affiliationWydział Lekarski : Instytut Kardiologiipl
dc.cm.date2021-10-15
dc.cm.id106092
dc.cm.idOmegaUJCMeff52b34b48d44ddaef85494e6589f41pl
dc.contributor.authorKleczyński, Paweł - 148282 pl
dc.contributor.authorKulbat, Aleksandrapl
dc.contributor.authorBrzychczy, Piotrpl
dc.contributor.authorDziewierz, Artur - 241962 pl
dc.contributor.authorTrębacz, Jarosławpl
dc.contributor.authorStapor, Maciejpl
dc.contributor.authorSorysz, Danutapl
dc.contributor.authorRzeszutko, Łukasz - 354634 pl
dc.contributor.authorBartuś, Stanisław - 227828 pl
dc.contributor.authorDudek, Dariusz - 129271 pl
dc.contributor.authorLegutko, Jacek - 130630 pl
dc.date.accession2022-02-01pl
dc.date.accessioned2021-10-15T09:01:38Z
dc.date.available2021-10-15T09:01:38Z
dc.date.issued2021pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.number20pl
dc.description.points140
dc.description.versionostateczna wersja wydawcy
dc.description.volume10pl
dc.identifier.articleid4657pl
dc.identifier.doi10.3390/jcm10204657pl
dc.identifier.eissn2077-0383pl
dc.identifier.issn2077-0383pl
dc.identifier.projectROD UJ / Opl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/280645
dc.identifier.weblinkhttps://www.mdpi.com/2077-0383/10/20/4657pl
dc.languageengpl
dc.language.containerengpl
dc.pbn.affiliationDziedzina nauk medycznych i nauk o zdrowiu : nauki medyczne
dc.relation.uri*
dc.rightsUdzielam licencji. Uznanie autorstwa 4.0 Międzynarodowa
dc.rights.licenceCC-BY
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/legalcode.pl
dc.share.typeOtwarte czasopismo
dc.subject.enaortic stenosis
dc.subject.enballoon aortic valvuloplasty
dc.subject.enbridge therapy
dc.subject.endestination therapy
dc.subject.enheart failure
dc.subtypeArticlepl
dc.titleBalloon aortic valvuloplasty for severe aortic stenosis as rescue or bridge therapypl
dc.title.journalJournal of Clinical Medicinepl
dc.typeJournalArticlepl
dspace.entity.typePublication
cris.lastimport.wos
2024-04-09T23:44:39Z
dc.abstract.en
The study aimed to assess procedural complications, patient flow and clinical outcomes after balloon aortic valvuloplasty (BAV) as rescue or bridge therapy, based on data from our registry. A total of 382 BAVs in 374 patients was performed. The main primary indication for BAV was a bridge for TAVI (n = 185, 49.4%). Other indications included a bridge for AVR (n = 26, 6.9%) and rescue procedure in hemodynamically unstable patients (n = 139, 37.2%). The mortality rate at 30 days, 6 and 12 months was 10.4%, 21.6%, 28.3%, respectively. In rescue patients, the death rate raised to 66.9% at 12 months. A significant improvement in symptoms was confirmed after BAV, after 30 days, 6 months, and in survivors after 1 year (p < 0.05 for all). Independent predictors of 12-month mortality were baseline STS score [HR (95% CI) 1.42 (1.34 to 2.88), p < 0.0001], baseline LVEF <20% [HR (95% CI) 1.89 (1.55–2.83), p < 0.0001] and LVEF <30% at 1 month [HR (95% CI) 1.97 (1.62–3.67), p < 0.0001] adjusted for age/gender. In everyday clinical practice in the TAVI era, there are still clinical indications to BAV a standalone procedure as a bridge to surgery, TAVI or for urgent high risk non-cardiac surgical procedures. Patients may improve clinically after BAV with LV function recovery, allowing to perform final therapy, within limited time window, for severe AS which ameliorates long-term outcomes. On the other hand, in patients for whom an isolated BAV becomes a destination therapy, prognosis is extremely poor.
dc.affiliationpl
Wydział Lekarski : Instytut Kardiologii
dc.cm.date
2021-10-15
dc.cm.id
106092
dc.cm.idOmegapl
UJCMeff52b34b48d44ddaef85494e6589f41
dc.contributor.authorpl
Kleczyński, Paweł - 148282
dc.contributor.authorpl
Kulbat, Aleksandra
dc.contributor.authorpl
Brzychczy, Piotr
dc.contributor.authorpl
Dziewierz, Artur - 241962
dc.contributor.authorpl
Trębacz, Jarosław
dc.contributor.authorpl
Stapor, Maciej
dc.contributor.authorpl
Sorysz, Danuta
dc.contributor.authorpl
Rzeszutko, Łukasz - 354634
dc.contributor.authorpl
Bartuś, Stanisław - 227828
dc.contributor.authorpl
Dudek, Dariusz - 129271
dc.contributor.authorpl
Legutko, Jacek - 130630
dc.date.accessionpl
2022-02-01
dc.date.accessioned
2021-10-15T09:01:38Z
dc.date.available
2021-10-15T09:01:38Z
dc.date.issuedpl
2021
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.numberpl
20
dc.description.points
140
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
10
dc.identifier.articleidpl
4657
dc.identifier.doipl
10.3390/jcm10204657
dc.identifier.eissnpl
2077-0383
dc.identifier.issnpl
2077-0383
dc.identifier.projectpl
ROD UJ / O
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/280645
dc.identifier.weblinkpl
https://www.mdpi.com/2077-0383/10/20/4657
dc.languagepl
eng
dc.language.containerpl
eng
dc.pbn.affiliation
Dziedzina nauk medycznych i nauk o zdrowiu : nauki medyczne
dc.relation.uri*
dc.rights
Udzielam licencji. Uznanie autorstwa 4.0 Międzynarodowa
dc.rights.licence
CC-BY
dc.rights.uri
http://creativecommons.org/licenses/by/4.0/legalcode.pl
dc.share.type
Otwarte czasopismo
dc.subject.en
aortic stenosis
dc.subject.en
balloon aortic valvuloplasty
dc.subject.en
bridge therapy
dc.subject.en
destination therapy
dc.subject.en
heart failure
dc.subtypepl
Article
dc.titlepl
Balloon aortic valvuloplasty for severe aortic stenosis as rescue or bridge therapy
dc.title.journalpl
Journal of Clinical Medicine
dc.typepl
JournalArticle
dspace.entity.type
Publication
Affiliations

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