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Study Plays Down Use of Balloons To Open Damaged Heart Valves

July 20, 1988

BOSTON (AP) _ The use of balloons to open up damaged aortic heart valves should be reserved for people who are too old and sick to undergo surgery to repair the condition, according to a new study.

The balloon technique is used as an alternative to surgery in people whose heart valves don’t work properly.

However, young, otherwise healthy patients with aortic valve narrowing should have surgery to replace the valve, Dr. Peter C. Block of Massachusetts General Hospital wrote in an editorial accompanying a report on the study.

The report is in the latest New England Journal of Medicine, which comes out Thursday.

The study, directed by Dr. Robert D. Safian of Beth Israel Hospital in Boston, examined the balloon technique’s value in people with malfunctioning aortic valves, which allow blood to flow into the aorta, the body’s main artery.

In about half of the 170 patients treated, the valves narrowed up again within a year of the procedure. Six of the patients, whose average age was 77, died in the hospital, and about three-fourths survived at least a year.

Block wrote that the balloon procedure may be useful for frail and sick elderly people who have other heart problems.

But he said elderly patients who have no other medical problems and are strong and willing to undergo surgery should be advised to choose surgery.

Results have been more promising when the balloon procedure is used to relieve narrowing of the mitral valve, which controls the flow of blood into the left ventricle, the heart’s main pumping chamber.

In another study reported in the journal, doctors concluded that open-heart surgery can be effective for people in their 80s. They reviewed the cases of 50 such people who underwent coronary bypass or valve replacement operations.

They calculated that 59 percent would still be alive after three years and 54 percent after five years.

The report, written by Dr. L. Henry Edmunds Jr. and others at the University of Pennsylvania, concludes that surgery is ″a reasonable therapeutic option″ in elderly people who cannot be treated in other ways, even though death and complication rates are high.

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