The Annals of Thoracic Surgery, Vol 49, 740-744, Copyright © 1990 by The Society of Thoracic Surgeons
Aortic valve operation after percutaneous aortic balloon valvuloplasty
RG Johnson, JS Dhillon, RL Thurer, RD Safian and RM Weintraub
Section of Cardiothoracic Surgery, Beth Israel Hospital, Harvard Medical School, Boston, Massachusetts.
From January 1986 to May 1988, 179 patients underwent percutaneous aortic
balloon valvuloplasty at our institution. Forty-five (25%) patients
subsequently required operation at this institution or other institutions.
The indication for percutaneous aortic balloon valvuloplasty was patient
preference in 15 and an estimation of excessive operative mortality in 30.
Three patients required emergency operation immediately after
valvuloplasty, and the other 42 had an elective operation a mean of 7.8
months afterward. All but 3 of these patients had major progression of
symptoms, and all had valvular restenosis. In spite of the high-risk status
of these patients, there were only four hospital deaths among the 45
patients. Three additional patients have died a mean of 11.4 months
postoperatively. The condition of all survivors remains clinically improved
after the valve operations. Percutaneous aortic balloon valvuloplasty must
be recognized as a palliative procedure, and should be reserved for
patients who are truly not candidates for operation or situations in which
a brief period of reduction in gradient might improve a patient's condition
before operation.
