The Safety and Feasibility of Gastrointestinal Cancer Surgery with the Aid of Balloon Aortic Valvuloplasty in Patients with Severe Aortic Stenosis

Abstract

AIM: Patients with severe aortic stenosis (AS) have been considered to be high-risk patients for noncardiac surgery. We evaluated the safety and feasibility of gastrointestinal (GI) cancer surgery after performing balloon aortic valvuloplasty (BAV) in patients with severe AS.

METHODS: A total of 16 patients who diagnosed with GI cancer and simultaneously met the criteria for AS intervention were included in this study. In our hospital, indications for AS intervention are as follows: (1) peak aortic valve velocity of > 4 m/sec and presence of exertional dyspnea; or (2) peak aortic valve velocity of > 5 m/sec. Our policy defined that cancer patients who meet these criteria undergo BAV in order to reduce the risk of noncardiac surgery for the treatment of cancer. We evaluated the outcomes of BAV and GI cancer surgery.

RESULTS: The echocardiographic data of AS was significantly improved after BAV. After BAV, mitral regurgitation occurred in 1 patient and transcatheter aortic valve implantation was required before GI cancer surgery in 1 patient. However, all enrolled patients proceeded to GI cancer surgery, which was performed uneventfully.

CONCLUSION: We demonstrated the safety and feasibility of GI cancer surgery after performing BAV in patients with severe AS. GI cancer surgery can be performed even in high-risk severe AS patients.