Case Report
Aortic Balloon Valvuloplasty Prior to Orthotopic Liver Transplantation: A Novel Approach to Aortic Stenosis and End-Stage Liver Disease
Table 1
Patient and procedural characteristics before and after valvuloplasty.
| | Patient 1 | Patient 2 | Patient 3 | Patient 4 |
| Age, y/sex | 58/female | 63/male | 56/male | 58/male | Diagnosis | Primary biliary Cirrhosis | Hemochromatosis | Nonalcoholic steatohepatitis | Hepatitis C | Platelet count | 101 | 101 | 24 | 38 | MELD score | 38 | 28 | 16 | 36 | BNP | 801 | 419 | 33 | 54 |
| Hemodynamic data | Pre | Post | Pre | Post | Pre | Post | Pre | Post |
| Gradients, mean (mmHg) | 37 | 28 | 45 | 16 | 35 | 25 | 45 | 25 | Aortic valve area (cm2)† | 0.8 | 1.0 | 0.6 | 1.2 | 1.0 | 1.1 | 0.7 | 1.1 | Ejection fraction | 60% | 64% | 60% | 70% | 65% | 70% | 68% | 65% |
| Procedure data | | | | | Time to transplant | 38 hrs | 4 mo | 6 hrs | 20 hrs | Balloon size | 23 mm, CRISTAL | | 23 mm, CRISTAL | 23 mm, Z-MED II | Sheath size | 8 French | 10 French | 10 French | 12 French | Sheath removal | Surgical, time of transplant | — | Surgical, 48 hrs after transplant | Time of transplant | Follow-up, mo/outcomes | 24 mo, alive, s/p AVR | 10 mo, alive | 24 mo, alive, s/p AVR |
Deceased, perivalvular abscess |
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Estimated by transthoracic echocardiographic measurement; continuity equation unrecorded.
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