Balloon dilatation of the aortic valve for inoperable aortic stenosis.

Abstract:

:The place of balloon dilatation of the aortic valve in the treatment of calcific aortic stenosis is controversial. Thirty two patients (mean age 76) in whom valve replacement was contraindicated were followed up for three to 24 months (mean 8); 25 were in functional class III or IV according to the New York Heart Association's classification. Major complications of the procedure occurred in four patients. Echocardiography and Doppler studies were performed before operation and before discharge in 28 patients, and the area of the valve was measured again six to 50 (mean 23) weeks after operation in 11 patients. The peak to peak aortic pressure gradient fell from a mean of 65 (SD 24) to 46 (20) mm Hg, but the area of the aortic valve, measured by Doppler echocardiography, in 18 patients showed a modest but significant increase, from 0.61 (0.16) to 0.74 (0.23) cm2. One month after dilatation, 29 patients were alive, of whom 17 had improved symptoms. Only two had lasting clinical benefit. Sixteen patients died, 12 of a cardiac cause. The estimated one year survival rate was 49%. Six patients underwent or required valve replacement because of persisting symptoms. In view of its limited long term efficacy balloon dilatation of the aortic valve should be used only for patients with severe symptoms whose life expectancy is limited by other disease or who are considered to be unsuitable for valve replacement. It may have a role in improving the condition of patients who present with cardiogenic shock or pulmonary oedema before valve replacement is undertaken.

journal_name

BMJ

authors

Sprigings DC,Jackson G,Chambers JB,Monaghan MJ,Thomas SD,Meany TB,Jewitt DE

doi

10.1136/bmj.297.6655.1007

subject

Has Abstract

pub_date

1988-10-22 00:00:00

pages

1007-11

issue

6655

eissn

0959-8138

issn

1756-1833

journal_volume

297

pub_type

杂志文章
  • Performance evaluation of a new rapid urine test for chlamydia in men: prospective cohort study.

    abstract:OBJECTIVE:To evaluate the performance of a rapid test for chlamydia with first void male urine samples as a potential tool for diagnosis and screening of chlamydial infection in men. DESIGN:Evaluation of test performance in prospective cohort study. Settings A young people's sexual health centre (site 1) and a genitou...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.b2655

    authors: Nadala EC,Goh BT,Magbanua JP,Barber P,Swain A,Alexander S,Laitila V,Michel CE,Mahilum-Tapay L,Ushiro-Lumb I,Ison C,Lee HH

    更新日期:2009-07-28 00:00:00

  • Large outbreak of food poisoning caused by Salmonella typhimurium definitive type 49 in mayonnaise.

    abstract::An investigation was conducted to determine the vehicle of infection of an outbreak of food poisoning in a large metropolitan building early in 1988. A questionnaire was distributed to 700 people who had eaten in the building during the week of the outbreak, and attack rates for specific food were calculated. Food and...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.298.6666.99

    authors: Mitchell E,O'Mahony M,Lynch D,Ward LR,Rowe B,Uttley A,Rogers T,Cunningham DG,Watson R

    更新日期:1989-01-14 00:00:00

  • Early evidence of ethnic differences in cardiovascular risk: cross sectional comparison of British South Asian and white children.

    abstract:OBJECTIVES:To examine whether British South Asian children differ in insulin resistance, adiposity, and cardiovascular risk profile from white children. DESIGN:Cross sectional study. SETTING:Primary schools in 10 British towns. PARTICIPANTS:British children aged 8 to 11 years (227 South Asian and 3415 white); 73 Sou...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.324.7338.635

    authors: Whincup PH,Gilg JA,Papacosta O,Seymour C,Miller GJ,Alberti KG,Cook DG

    更新日期:2002-03-16 00:00:00

  • Birth weight and non-insulin dependent diabetes: thrifty genotype, thrifty phenotype, or surviving small baby genotype?

    abstract:OBJECTIVE:To determine the prevalence of diabetes in relation to birth weight in Pima Indians. DESIGN:Follow up study of infants born during 1940-72 who had undergone a glucose tolerance test at ages 20-39 years. SETTING:Gila River Indian community, Arizona. SUBJECTS:1179 American Indians. MAIN OUTCOME MEASURE:Prev...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.308.6934.942

    authors: McCance DR,Pettitt DJ,Hanson RL,Jacobsson LT,Knowler WC,Bennett PH

    更新日期:1994-04-09 00:00:00

  • Perinatal mortality and morbidity among babies delivered in water: surveillance study and postal survey.

    abstract:AIM:To compare perinatal morbidity and mortality for babies delivered in water with rates for babies delivered conventionally (not in water). DESIGN:Surveillance study (of all consultant paediatricians) and postal survey (of all NHS maternity units). SETTING:British Isles (surveillance study); England and Wales (post...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.319.7208.483

    authors: Gilbert RE,Tookey PA

    更新日期:1999-08-21 00:00:00

  • Suicide within 12 months of contact with mental health services: national clinical survey.

    abstract:OBJECTIVE:To describe the clinical circumstances in which psychiatric patients commit suicide. DESIGN:National clinical survey. SETTING:England and Wales. SUBJECTS:A two year sample of people who had committed suicide, in particular those who had been in contact with mental health services in the 12 months before de...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.318.7193.1235

    authors: Appleby L,Shaw J,Amos T,McDonnell R,Harris C,McCann K,Kiernan K,Davies S,Bickley H,Parsons R

    更新日期:1999-05-08 00:00:00

  • Effectiveness of teaching general practitioners skills in brief cognitive behaviour therapy to treat patients with depression: randomised controlled trial.

    abstract:OBJECTIVE:To assess the effectiveness of teaching general practitioners skills in brief cognitive behaviour therapy. DESIGN:Parallel group, cluster randomised, controlled trial of an educational package on cognitive behaviour therapy. SETTING:General practices in north London. PARTICIPANTS:84 general practitioner pr...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.324.7343.947

    authors: King M,Davidson O,Taylor F,Haines A,Sharp D,Turner R

    更新日期:2002-04-20 00:00:00

  • Umbilical cord clamping and preterm infants: a randomised trial.

    abstract:OBJECTIVE:To investigate the clinical effects of regulating umbilical cord clamping in preterm infants. DESIGN:A prospective randomised study. SETTING:The Queen Mother's Hospital, Glasgow. SUBJECTS:36 vaginally delivered infants over 27 and under 33 weeks' gestation. INTERVENTION:Holding the infant 20 cm below the ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.306.6871.172

    authors: Kinmond S,Aitchison TC,Holland BM,Jones JG,Turner TL,Wardrop CA

    更新日期:1993-01-16 00:00:00

  • Baby food industry lobbies WHO on breast feeding advice.

    abstract::In the existing WHO guidelines, complementary feeding at 4-6 months is advocated. However, many nutrition specialists believe that these guidelines lead to complementary foods being offered from the age of 3 months, or even earlier, subsequently suggesting that the WHO should change its recommendations to about 6 mon...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 新闻

    doi:

    authors: Yamey G

    更新日期:2000-09-09 00:00:00

  • Eradication of methicillin resistant Staphylococcus aureus by "ring fencing" of elective orthopaedic beds.

    abstract:PROBLEM:Deep infection after joint arthroplasty can be catastrophic, leading to further surgery, loss of the prosthesis, disability, and risk of mortality. Twenty nine new cases of methicillin resistant Staphylococcus aureus occurred in the first year after elective orthopaedic surgery was centralised to a district gen...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.329.7458.149

    authors: Biant LC,Teare EL,Williams WW,Tuite JD

    更新日期:2004-07-17 00:00:00

  • Where have all the pennies gone? The work of Manchester Medical Audit Advisory Group.

    abstract::Medical audit has its critics, who point to the large sums of NHS cash that seem to be disappearing down a medical plughole. These criticisms are recognised by medical audit advisory groups but there are many reasons why the work of these groups has not yet resulted in many publications in journals or bumped up health...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.309.6947.98

    authors: Johnson R

    更新日期:1994-07-09 00:00:00

  • Socioeconomic position in childhood and adulthood and insulin resistance: cross sectional survey using data from British women's heart and health study.

    abstract:OBJECTIVE:To assess the associations between childhood and adulthood social class and insulin resistance. DESIGN:Cross sectional survey. SETTING:23 towns across England, Scotland, and Wales. PARTICIPANTS:4286 women aged 60-79 years. MAIN OUTCOME MEASURES:Insulin resistance and other cardiovascular disease risk fact...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.325.7368.805

    authors: Lawlor DA,Ebrahim S,Davey Smith G,British women's heart and health study.

    更新日期:2002-10-12 00:00:00

  • Hysterectomy, endometrial ablation, and levonorgestrel releasing intrauterine system (Mirena) for treatment of heavy menstrual bleeding: cost effectiveness analysis.

    abstract:OBJECTIVE:To undertake a cost effectiveness analysis comparing first and second generation endometrial ablative techniques, hysterectomy, and the levonorgestrel releasing intrauterine system (Mirena) for treating heavy menstrual bleeding. DESIGN:Model based economic evaluation with data from an individual patient data...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.d2202

    authors: Roberts TE,Tsourapas A,Middleton LJ,Champaneria R,Daniels JP,Cooper KG,Bhattacharya S,Barton PM

    更新日期:2011-04-26 00:00:00

  • Searching for unpublished data for Cochrane reviews: cross sectional study.

    abstract:OBJECTIVE:To describe the experiences of authors of Cochrane reviews in searching for, getting access to, and using unpublished data. DESIGN:Cross sectional study. SETTING:Cochrane reviews. PARTICIPANTS:2184 corresponding authors of Cochrane reviews as of May 2012. MAIN OUTCOME MEASURE:Frequencies of responses to o...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.f2231

    authors: Schroll JB,Bero L,Gøtzsche PC

    更新日期:2013-04-23 00:00:00

  • Effectiveness of dementia follow-up care by memory clinics or general practitioners: randomised controlled trial.

    abstract:OBJECTIVE:To examine the effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared with general practitioners. DESIGN:Multicentre randomised controlled trial. SETTING:Nine memory clinics and 159 general practitioners in the Netherlands. PARTICIPANTS:175 patients with a ne...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.e3086

    authors: Meeuwsen EJ,Melis RJ,Van Der Aa GC,Golüke-Willemse GA,De Leest BJ,Van Raak FH,Schölzel-Dorenbos CJ,Verheijen DC,Verhey FR,Visser MC,Wolfs CA,Adang EM,Olde Rikkert MG

    更新日期:2012-05-15 00:00:00

  • Managed care. Origins, principles, and evolution.

    abstract::Managed care has entered the lexicon of healthcare reform, but confusion and ignorance surround its meaning and purpose. It seeks to cut the costs of health care while maintaining its quality, but the evidence that it is able to achieve these aims is mixed. As well as raising awareness and understanding of the issues ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.314.7097.1823

    authors: Fairfield G,Hunter DJ,Mechanic D,Rosleff F

    更新日期:1997-06-21 00:00:00

  • Overprescription of cholera vaccine to travellers by general practitioners.

    abstract::A questionnaire describing five hypothetical patients intending to travel to different countries was sent to 113 general practitioners, who were asked to state which patients they would recommend cholera vaccination to. The response rate was 80%. The general practitioners' recommendations were compared with those of t...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.300.6716.25

    authors: Mott A,Kinnersley P

    更新日期:1990-01-06 00:00:00

  • Randomised placebo controlled multicentre trial to assess short term clarithromycin for patients with stable coronary heart disease: CLARICOR trial.

    abstract:OBJECTIVE:To determine if the macrolide clarithromycin affects mortality and cardiovascular morbidity in patients with stable coronary heart disease. DESIGN:Centrally randomised multicentre trial. All parties at all stages were blinded. Analyses were by intention to treat. SETTING:Five Copenhagen University cardiolog...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.38666.653600.55

    authors: Jespersen CM,Als-Nielsen B,Damgaard M,Hansen JF,Hansen S,Helø OH,Hildebrandt P,Hilden J,Jensen GB,Kastrup J,Kolmos HJ,Kjøller E,Lind I,Nielsen H,Petersen L,Gluud C,CLARICOR Trial Group.

    更新日期:2006-01-07 00:00:00

  • Weight growth in infants born to mothers who smoked during pregnancy.

    abstract:OBJECTIVE:To determine whether maternal smoking during pregnancy causes impairment in growth after birth. DESIGN:Longitudinal study. SETTING:Six medical university centres of six towns of north, central, and south Italy. SUBJECTS:12,987 babies (10,238 born from non-smoking mothers, 2276 from mothers smoking one to n...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6982.768

    authors: Conter V,Cortinovis I,Rogari P,Riva L

    更新日期:1995-03-25 00:00:00

  • Hemiarthroplasty or internal fixation for intracapsular displaced femoral neck fractures: randomised controlled trial.

    abstract:OBJECTIVE:To compare the functional results after displaced fractures of the femoral neck treated with internal fixation or hemiarthroplasty. DESIGN:Randomised trial with blinding of assessments of functional results. SETTING:University hospital. PARTICIPANTS:222 patients; 165 (74%) women, mean age 83 years. Inclusi...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,随机对照试验

    doi:10.1136/bmj.39399.456551.25

    authors: Frihagen F,Nordsletten L,Madsen JE

    更新日期:2007-12-15 00:00:00

  • Interpractice audit of diagnosis and management of hypertension in primary care: educational intervention and review of medical records.

    abstract:OBJECTIVE:To determine whether peer review medical audit in a primary care setting changes clinical behaviour in relation to the management of hypertension. DESIGN:Review of medical records in general practices to identify hypertensive patients followed up by assessment of the pre-educational and post-educational mana...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.314.7085.942

    authors: Mashru M,Lant A

    更新日期:1997-03-29 00:00:00

  • Accuracy of mini peak flow meters in indicating changes in lung function in children with asthma.

    abstract:OBJECTIVE:To assess whether mini flow meters used to measure peak expiratory flow can track changes in lung function and indicate clinically important changes. DESIGN:Comparison of measurements with a spirometer and different brands of mini flow meter; the meters were allocated to subjects haphazardly. SUBJECTS:12 bo...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章

    doi:10.1136/bmj.308.6928.572

    authors: Sly PD,Cahill P,Willet K,Burton P

    更新日期:1994-02-26 00:00:00

  • Effectiveness of corticosteroid injections versus physiotherapy for treatment of painful stiff shoulder in primary care: randomised trial.

    abstract:OBJECTIVE:To compare the effectiveness of corticosteroid injections with physiotherapy for the treatment of painful stiff shoulder. DESIGN:Randomised trial. SETTING:40 general practices. SUBJECTS:109 patients consulting general practitioners for shoulder pain were enrolled in the trial. INTERVENTIONS:Patients were ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.317.7168.1292

    authors: van der Windt DA,Koes BW,Devillé W,Boeke AJ,de Jong BA,Bouter LM

    更新日期:1998-11-07 00:00:00

  • Accuracy of the "traffic light" clinical decision rule for serious bacterial infections in young children with fever: a retrospective cohort study.

    abstract:OBJECTIVES:To determine the accuracy of a clinical decision rule (the traffic light system developed by the National Institute for Health and Clinical Excellence (NICE)) for detecting three common serious bacterial infections (urinary tract infection, pneumonia, and bacteraemia) in young febrile children. DESIGN:Retro...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.f866

    authors: De S,Williams GJ,Hayen A,Macaskill P,McCaskill M,Isaacs D,Craig JC

    更新日期:2013-02-13 00:00:00

  • Incidence of gastric cancer among patients with gastric precancerous lesions: observational cohort study in a low risk Western population.

    abstract:OBJECTIVE:To accurately measure the incidence of gastric cancer among patients with gastric precancerous lesions, and to quantify the excess incidence in comparison with people with normal mucosa on endoscopy and a general population. DESIGN:Population based cohort study. SETTING:Population of Sweden using data from ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.h3867

    authors: Song H,Ekheden IG,Zheng Z,Ericsson J,Nyrén O,Ye W

    更新日期:2015-07-27 00:00:00

  • Understanding influences on smoking in Bangladeshi and Pakistani adults: community based, qualitative study.

    abstract:OBJECTIVE:To gain detailed understanding of influences on smoking behaviour in Bangladeshi and Pakistani communities in the United Kingdom to inform the development of effective and culturally acceptable smoking cessation interventions. DESIGN:Qualitative study using community participatory methods, purposeful samplin...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.326.7396.962

    authors: Bush J,White M,Kai J,Rankin J,Bhopal R

    更新日期:2003-05-03 00:00:00

  • Socioeconomic deprivation and notification rates for tuberculosis in London during 1982-91.

    abstract:OBJECTIVES:To investigate the association between four sociodemographic measures (unemployment, overcrowding, low social class, and the proportion of migrants from areas of high prevalence of tuberculosis) and average level and rate of change of notification rates for tuberculosis. DESIGN:Ecological analysis of both t...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6985.963

    authors: Mangtani P,Jolley DJ,Watson JM,Rodrigues LC

    更新日期:1995-04-15 00:00:00

  • A qualitative study of action plans for asthma.

    abstract:OBJECTIVES:To investigate the perspectives of patients with asthma on the use of an action plan and the implementation of this plan during an asthma attack that culminated in a visit to an emergency department. DESIGN:Qualitative study. SETTING:Tertiary teaching hospital, suburban hospital, and rural hospital. PARTI...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.324.7344.1003

    authors: Douglass J,Aroni R,Goeman D,Stewart K,Sawyer S,Thien F,Abramson M

    更新日期:2002-04-27 00:00:00

  • High mortality by natural and unnatural causes: a 10 year follow up study of patients admitted to a poisoning treatment centre after suicide attempts.

    abstract:OBJECTIVE:To describe mortality by suicide and other causes of death in a group of patients who attempted suicide, and to identify predictive factors. DESIGN:10 year follow up study based on records of suicide attempters in 1980. SETTING:Poisoning treatment centre at a general hospital. SUBJECTS:974 patients aged 15...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.306.6893.1637

    authors: Nordentoft M,Breum L,Munck LK,Nordestgaard AG,Hunding A,Laursen Bjaeldager PA

    更新日期:1993-06-19 00:00:00

  • Avoiding the pitfalls of sponsored multicentre research in general practice.

    abstract::Research in general practice is becoming increasingly popular, and most general practitioners will sooner or later have to decide whether to become involved with clinical trials sponsored by drug companies. This paper outlines the advantages and disadvantages of multicentre research--based on experience of running a r...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.307.6915.1331

    authors: Waldron HA,Cookson RF

    更新日期:1993-11-20 00:00:00