The Therapeutic Efficacy of Antegrade Balloon Aortic Valvuloplasty under Intra-aortic Balloon Pumping for Treating Cardiogenic Shock due to Critical Aortic Valve Stenosis
Journal Title: International Cardiovascular Research Journal - Year 2017, Vol 11, Issue 2
Abstract
Background: Treatment of critical Aortic Stenosis (AS) in hemodynamically unstable patients is a major clinical challenge. Objectives: This study aimed to retrospectively investigate the safety of antegrade Balloon Aortic Valvuloplasty (BAV) using the Inoue balloon and an Intra-Aortic Balloon Pump (IABP) for treating AS with cardiogenic shock and to determine the immediate efficacy of the procedure with respect to hemodynamic improvements in patients with critical symptomatic AS. Patients and Methods: This retrospective study was conducted on 47 symptomatic critical AS patients excluded from undergoing surgical aortic valve replacement who were treated using antegrade BAV. The high-risk group included 14 cases whose mean Left Atrial Pressure (LAP) remained above 25 mmHg despite aggressive medical therapy. These cases were treated using antegrade BAV and an IABP (BAV-IABP group). On the other hand, 33 cases with stable hemodynamics due to medications comprised the relatively low-risk group and were treated using antegrade BAV alone (BAV-alone group). Results: Immediate procedural success was achieved in all cases within 24 h. In the BAVIABP group, the proportion of patients with improved aortic valve areas (125.6 ± 56.7% vs. 70.9 ± 32.3%, P < 0.004), reduced pressure gradients (67.8 ± 9.1% vs. 59.6 ± 17.2%, P < 0.040), and decreased LAP (48.4 ± 15.4% vs. 17.9±9.9%, P < 0.001) was significantly larger compared to the BAV-alone group. Conclusions: Antegrade BAV under IABP provided safe and effective immediate valvuloplasty in very high-risk patients who were not suitable for definitive therapy.
The Effects of Omega-3 on Liver Damage after Acute Myocardial Infarction: A Randomized Controlled Clinical Trial
Background: Abnormal liver function test results are often observed in patients with acute Myocardial Infarction (MI). Objectives: This study aimed to evaluate the effects of omega-3 fatty acids on Alanine Aminotransfera...
The Effect of Fasting on Anthropometric Parameters and Blood Pressure Levels: A Report from Southern Iran
Background: Ramadan is the fasting month among Muslims and the change in eating and sleep pattern can cause changes in human health. Objectives: This study was carried out to determine the effect of fasting in Ramadan on...
A Survey on Structural and Functional Cardiac Abnormalities in Transfusion-Dependent Thalassemia, a Report from South-East of Iran
Background: Cardiac abnormalities are common complications in Transfusion Dependent Thalassemia (TDT). Objectives: This study aimed to assess functional and structural cardiac abnormalities in TDT patients in Zabol, Sist...
Nurses’ Knowledge and Practices of Electrocardiogram Interpretation
Background: Electrocardiogram (ECG) is a diagnostic tool that is routinely used noninvasively to assess the electrical and muscular functions of the heart. All nurses should be able to recognize basic ECG rhythms. Object...
CT Image Overlay on Live X-Ray as Guidance for Intervention on a Right Coronary Artery Arising from the Left Coronary Sinus
For patients with coronary anomalies, interventions can be challenging. This case report describes a coronary intervention on a patient with a right coronary artery arising from the left coronary sinus facilitated by CT-...