Author/Editor		Dovč, Klemen; Markota, Andrej; Kanič, Vojko; Bombek, Mirko; Prosen, Gregor
Title		Percutaneous balloon aortic valvuloplasty: palliative treatment for inoperable patients?
Translated title		Perkutana balonska aortna valvuloplastika kot možnost paliativnega zdravljenja za inoperabilne bolnike?
Type		članek
Vol. and No.		Letnik 4, št. 2
Publication year		2011
Volume		str. 69-72
ISSN		1855-5640 - Acta medico-biotechnica : AMB
Language		eng
Abstract		Namen: V razvitih državah se zaradi staranja prebivalstva povečuje število starostnikov s hudo aortno stenozo. Tveganje za zaplete je pri kirurški zamenjavi aortne zaklopke, ki je standarden način zdravljenja, pri tej skupini bolnikov visoko. Za zdravljenje omenjene skupine starostnikov razvijajo perkutane načine zdravljenja, kot sta perkutana balonska aortna valvuloplastika in perkutana vstavitev aortne zaklopke. Prikaz primera: V prispevku je opisan primer 84-letne bolnice z levostransko hemiparezo po možganski kapi in generalizirano aterosklerozo. Sprejeta je bila zaradi pljučnega edema, zdravljenje z neinvazivno ventilacijo in inotropi pa ni bilo uspešno. Perkutana balonska aortna valvuloplastika je bila opravljena 6 ur po sprejemu. Takoj po posegu se je bolničino stanje izboljšalo. Po 25 dneh bolnišničnega zdravljenja smo jo odpustili v domsko varstvo. Zaključek: Perkutana balonska vulvoloplastika je dodatna možnost zdravljenja bolnikov z aortno stenozo in visokim tveganjem za zaplete ob kirurškem zdravljenju. Balonska dilatacija aortne zaklopke ima lahko vlogo paliativnega posega ali premostitvenega posega do kirurške ali perkutane zamenjave aortne zaklopke.Purpose: The number of elderly patients with severe aortic stenosis and comorbidities is increasing in the aging populations of "developed" countries. Unacceptably high perioperative mortality and morbidity makes the decision to undertake surgical aortic valve replacement in this group of patients difficult and unlikely. Development of less invasive procedures such as balloon aortic valvuloplasty and transcatheter aortic valve replacement is emerging as another treatment option. Case report: A 84-year-old female with previous left-sided hemiparesis after stroke and severe aortic stenosis presented with pulmonary edema to our institution. Non-invasive ventilation and inotropic support were unsuccessful. Balloon aortic valvuloplasty was done as emergency procedure and she improved immediately. She was discharged after 25 days of inhospital treatment. She died 8 weeks later of unrelated reasons (infected decubitus and sepsis). Conclusion: Balloon aortic valvuloplasty might be used as temporary and interim therapeutical options for patients with severe aortic stenosis and acute left ventricular failure who have unacceptably high risks when aortic valve replacement or emergency transcatheter aortic valve implantation is considered. Balloon aortic valvuloplasty may be used as a bridge to both procedures
Descriptors		Aortic Valve Stenosis Aortna zaklopka, stenoza Heart Failure Srčna odpoved Balloon Dilation Balonska dilatacija therapy Zdravljenje