BACKGROUND Balloon aortic valvuloplasty (BAV) offers an alternative to conventional aortic valve replacement in elderly and frail patients with severe aortic stenosis (AS) for whom there are no other effective options. We aimed to investigate the mid-term effect of BAV on mitral regurgitation (MR) in patients with severe AS. METHODS Our analysis was based on the data from 83 patients with severe AS (mean age, 86 ± 5 years; female, 68) treated using BAV. Echocardiography was performed before the procedure and at 1 and 3 months after. MR was quantified by measuring the MR jet area, with more-than-moderate MR being clinically significant. RESULTS Forty patients were classified in this group (MR group). Significant reduction of MR was observed in the MR group at 1 month and 3 months after procedure, with no improvement in patients in the non-MR group. At 3 months, 15 of the 40 patients in the MR group still had significant MR, with the change at 1 month in the left ventricular end-systolic dimension (OR: 1.36; 95% CI: 1.05-1.76; P = 0.022) and MR jet area (OR: 1.95; 95% CI: 1.16-3.29; P = 0.012) being predictive of persisting significant MR at 3 months after BAV. The prevalence of New York Heart Association functional class III or IV decreased at 1 and 3 months after BAV in both groups. CONCLUSIONS BAV provides a useful therapeutic strategy for elderly patients with severe AS who are not candidates for surgical or transcatheter aortic valve replacement, especially in those with significant MR.

中文翻译：

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球囊主动脉瓣成形术对二尖瓣返流的中期效果。

背景技术球囊主动脉瓣膜成形术（BAV）为患有重度主动脉瓣狭窄（AS）的老年和体弱患者而没有其他有效选择的常规主动脉瓣置换术提供了替代方案。我们旨在调查BAV对重症AS患者二尖瓣反流（MR）的中期效果。方法我们的分析基于83例接受BAV治疗的严重AS患者（平均年龄86±5岁；女性68岁）的数据。超声心动图检查是在手术前以及术后1和3个月进行的。MR是通过测量MR射流面积来量化的，超过中等水平的MR具有重要的临床意义。结果该组（MR组）分为40例。术后1个月和3个月，MR组的MR明显降低，非MR组患者无改善。在3个月时，MR组40例患者中有15例仍具有明显的MR，在1个月时左心室收缩末期改变（OR：1.36； 95％CI：1.05-1.76； P = 0.022），并且MR射流面积（OR：1.95； 95％CI：1.16-3.29； P = 0.012）可预示BAV后3个月持续存在显着MR。两组在BAV后1个月和3个月时，纽约心脏协会功能性III或IV级患病率均下降。结论BAV为严重AS的老年患者提供了一种有用的治疗策略，这些老年人不适合手术或经导管主动脉瓣置换，尤其是那些具有MR的患者。在1个月时左心室收缩末期尺寸改变（OR：1.36; 95％CI：1.05-1.76; P = 0.022）和MR射流面积（OR：1.95; 95％CI：1.16-3.29; P = 0.012）可预示BAV后3个月仍会持续存在明显的MR。两组在BAV后1个月和3个月时，纽约心脏协会功能性III或IV级患病率均下降。结论BAV为严重AS的老年患者提供了一种有用的治疗策略，这些老年AS患者不适合手术或经导管主动脉瓣置换，尤其是那些具有MR的患者。在1个月时左心室收缩末期尺寸改变（OR：1.36; 95％CI：1.05-1.76; P = 0.022）和MR射流面积（OR：1.95; 95％CI：1.16-3.29; P = 0.012）可预示BAV后3个月仍会持续存在明显的MR。两组在BAV后1个月和3个月时，纽约心脏协会功能性III或IV级患病率均下降。结论BAV为严重AS的老年患者提供了一种有用的治疗策略，这些老年人不适合手术或经导管主动脉瓣置换，尤其是那些具有MR的患者。两组在BAV后1个月和3个月时，纽约心脏协会功能性III或IV级患病率均下降。结论BAV为严重AS的老年患者提供了一种有用的治疗策略，这些老年人不适合手术或经导管主动脉瓣置换，尤其是那些具有MR的患者。两组在BAV后1个月和3个月时，纽约心脏协会功能性III或IV级患病率均下降。结论BAV为严重AS的老年患者提供了一种有用的治疗策略，这些老年人不适合手术或经导管主动脉瓣置换，尤其是那些具有MR的患者。