CRT-710 Gender Differences in Clinical Presentation, and Outcomes of Patients Undergoing Balloon Aortic Valvuloplasty
Radhika GadesamLakshmana PendyalaItsik Ben‐DorSa’ar MinhaRebecca TorgusonJoshua P. LohOmar AlfazirMichael J. LipinskiWenjie TianHideaki OtaRon Waksman
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Aortic valvuloplasty
Presentation (obstetrics)
Balloon valvuloplasty
The Inoue balloon, invented for percutaneous transseptal mitral commissurotomy for mitral stenosis, is initially dilated in the distal portion and then the proximal portion, forming an hourglass shape that stabilizes the balloon at the mitral valve orifice with a pulling action. The device has been successfully applied to antegrade aortic valvuloplasty; the hourglass shape stabilizes the balloon across the aortic valve without rapid ventricular pacing. Subsequently, an Inoue balloon was developed for retrograde aortic valvuloplasty using the same design as the antegrade balloon. The hourglass-shaped balloon, however, has difficulty maintaining stability across the aortic valve because the distal portion of the balloon, which inflates first, directly receives systolic pressure from the left ventricle. A novel Inoue balloon was invented to overcome this issue by altering the manner of inflation: the proximal portion inflates first, followed by the distal portion. Theoretically, the proximal portion, which initially inflates just above the aortic valve, remains secure across the valve by applying a pressing force that counteracts the systolic forward pressure. Furthermore, a radiopaque marker is placed at the center of the balloon to enable rapid and precise balloon adjustment. We present a case involving a 65-year-old female hemodialysis patient with severe symptomatic aortic stenosis who we successfully treated with balloon aortic valvuloplasty using the novel Inoue balloon followed by transcatheter aortic valve implantation. The present case demonstrates the feasibility and effectiveness of the novel "proximal first" Inoue balloon for retrograde balloon aortic valvuloplasty for severe aortic stenosis.
Aortic valvuloplasty
Balloon valvuloplasty
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Aortic valvuloplasty
Balloon valvuloplasty
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Aortic valvuloplasty
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We present a 1,600 g infant who underwent successful balloon aortic valvuloplasty from the right carotid artery approach. A simple technique to facilitate access to the left ventricle and expedite the procedure is described. Issues unique to performing balloon aortic valvuloplasty on such a small child are discussed.
Aortic valvuloplasty
Balloon valvuloplasty
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Aortic valvuloplasty
Balloon valvuloplasty
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Aortic valvuloplasty
Balloon valvuloplasty
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When percutaneous balloon valvuloplasty was introduced in the 1980s, it seemed an ideal alternative to valve replacement for elderly or seriously disabled patients. However, the long-term outcomes of balloon valvuloplasty have been disappointing, particularly in patients with …
Aortic valvuloplasty
Balloon valvuloplasty
Valve replacement
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Abstract The burden of pregnancy in patients with severe mitral stenosis continues to present a therapeutic challenge. We present two such cases successfully treated with balloon valvuloplasty using the Inoue balloon. The unique features of this balloon may render it the technique of choice for selected pregnant patients with severe mitral stenosis.
Balloon valvuloplasty
Mitral valve stenosis
Mitral valvuloplasty
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While investigating the outcomes of balloon dilatation procedures in patients with congenital obstructive lesions of the heart, several parallel observations were made. The purpose of this review is to present these observations/phenomena/innovations related to balloon dilatation of pulmonary stenosis (PS), aortic stenosis (AS), and aortic coarctation (AC). In subjects who had balloon pulmonary valvuloplasty (BPV), development of infundibular obstruction, electrocardiographic (ECG) changes, changes in right ventricular filling, role of balloon/annulus ratios on the results of BPV, and double balloon vs. single balloon BPV will be reviewed. In patients who had balloon aortic valvuloplasty (BAV), causes of aortic insufficiency and trans-umbilical venous approach for BAV are tackled. In children who had balloon angioplasty (BA) of AC, aortic remodeling and biophysical response after BA of AC are discussed.
Aortic valvuloplasty
Balloon dilatation
Balloon valvuloplasty
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Balloon valvuloplasty
Mitral valvuloplasty
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