Carlo Rostagno, Alessandro Cartei, Roberto Buzzi and Gennaro Santoro
Aortic Ballon Valvuloplasty is still a Valuable Option for High Risk Patients with Severe Aortic Stenosis before Surgery for Hip Fracture
Early treatment of hip fracture in the elderly has been reported to increase long-term survival and favor functional recovery. Comorbidities are common in this population and may negatively affect survival after surgery. Severe aortic stenosis has been reported in 5-10% of patients with hip fracture. Patients with low left ventricular ejection fraction and subject with other severe comorbidities are at particular high risk when they need to undergo major non cardiac surgery. In aortic stenosis hip surgery, a high bleeding risk condition, 9 a, may be associated with a severe lowoutput state. In patients who require urgent major non-cardiac surgery balloon aortic valvuloplasty may decrease pressure overload and perioperative risk? The procedure is suggested by the recent ESC guidelines (recommendation Class IIb), but not by AHA/ACC guidelines. The two cases of high risk severe aortic stenosis treated with aortic balloon valvuloplasty undergoing thereafter uneventful hip surgery suggest that aortic valve balloon valvuloplasty may still be useful in selected patients.
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