Aortic percutaneous transluminal valvuloplasty in elderly patients by balloon larger than aortic anulus

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Abstract
Twenty‐four elderly patients (79 ± 7 years) with long‐standing calcified aortic stenosis have been divided in two comparable groups of 12. The first group was treated with 19 mm balloon percutaneous transluminal valvuloplasty, where the balloon diameter was always smaller than the aortic anulus diameter. Peak‐to‐peak aortic valve gradient decreased from 76 ± 32 mmHg to 30 ± 19 (P > .05), and the aortic valve area, calculated by Gorlin formula, increased from 0.40 ± 0.17 cm2 to 0.57 ± 0.17 (P > .05). The second group was treated with a trefoil 25 mm balloon, always larger than the aortic anulus diameter. In this second group, peak‐to‐peak aortic valve gradient decreased from 73 ± 34 mmHg to 23 ± 15 (P > .05), and aortic valve area increased from 0.47 ± 0.14 cm2 to 0.88 ± 0.36 (P > .05), increasing thus more than in group | (P > .05).Clinical tolerance to balloon inflation was not the same according to individual patients but was similar between the two groups; complications were comparable in the two groups. These results suggest that aortic valvuloplasty by trefoil balloon larger than aortic anulus can provide wider aortic valve area without increasing complication rate.