The risk for systemic embolization associated with percutaneous balloon valvuloplasty in adults. A prospective comprehensive evaluation.

Published

Journal Article

STUDY OBJECTIVE: To prospectively investigate the evidence for embolic phenomena associated with percutaneous mitral and aortic valvuloplasty. DESIGN: Prospective, consecutive case series before and after balloon valvuloplasty. SETTING: Referral center hospital and cardiac catheterization laboratory. PATIENTS: Consecutive sample of 32 patients having balloon valvuloplasty for critical symptomatic stenosis of the mitral or aortic valve. Twenty-six patients had aortic stenosis; 6 had mitral stenosis. INTERVENTION: Computed tomography of the head, funduscopy, and electrocardiography were done in all patients before and after valvuloplasty. Cardiac isoenzymes were measured serially in 19 patients. MEASUREMENTS AND MAIN RESULTS: Previous cerebral infarction was seen in nine patients, with three showing a new abnormality after aortic valvuloplasty. In one of these patients a funduscopic hemorrhage was detected by photography. Total creatinine kinase and MB fraction were elevated in 1 of 19 patients. Serial electrocardiograms were unchanged in all patients. CONCLUSIONS: The incidence of cerebral neurologic events and myocardial injury are acceptably low after balloon valvuloplasty of calcific aortic and mitral stenosis. Both episodes of symptomatic cerebral infarction occurred in patients with apparent bicuspid aortic valvular stenosis, suggesting that calcific bicuspid aortic stenosis may be associated with more neurologic events after aortic valvuloplasty.

Full Text

Duke Authors

Cited Authors

  • Davidson, CJ; Skelton, TN; Kisslo, KB; Kong, Y; Peter, RH; Simonton, CA; Phillips, HR; Behar, VS; Bashore, TM

Published Date

  • April 1, 1988

Published In

Volume / Issue

  • 108 / 4

Start / End Page

  • 557 - 560

PubMed ID

  • 3348563

Pubmed Central ID

  • 3348563

International Standard Serial Number (ISSN)

  • 0003-4819

Digital Object Identifier (DOI)

  • 10.7326/0003-4819-108-4-557

Language

  • eng

Conference Location

  • United States