Implante por cateter de bioprótese valvar para tratamento da estenose aórtica: experiência de três anos

Brito, Fábio Sândoli de; Abizaid, Alexandre; Almeida, Breno Oliveira; Caixeta, Adriano; Tarasoutchi, Flávio; Grube, Eberhard; Perin, Marco Antônio

doi:10.1590/s0066-782x2012005000063

Cited by 4 publications

(5 citation statements)

References 33 publications

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“…Device success was attained in 84% of cases, which is in agreement with other current series 6,23 . Initially, the definition of device success was focused on the implantation of a single prosthesis in the correct anatomic position and without postoperative mortality, whereas the new definition proposed by VARC-2 includes the latter, as well as the hemodynamic function of the prosthetic valve.…”

Section: Discussionsupporting

confidence: 92%

“…Although the patients included here have high risk of morbidity and mortality, with a mean EuroScore of 23%, mortality from all causes was 14%, which is similar to or lower than that reported in other national and international case series 6,7,14,15 . It is noteworthy that mortality is also related to the learning curve of the multidisciplinary team, as when the first 40 patients were excluded, the mortality rate decreased to 8.1%.…”

Section: Discussionsupporting

confidence: 75%

“…The present study represents, together with the registry by Albert Einstein Hospital 6 , the initial national experience with percutaneous implantation of aortic valve prosthesis, being the largest Brazilian series by the same group, using three different types of prosthesis and different access routes.…”

Section: Discussionmentioning

confidence: 99%

“…However, the relatively high cost of this new technology makes its incorporation into the routine of most hospitals in Brazil to be slow, despite its important benefits in the short and middle-term 6-9 .…”

Section: Introductionmentioning

confidence: 99%

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Initial Experience of Two National Centers in Transcatheter Aortic Prosthesis Implantation

Lluberas¹,

Abizaid²,

Siqueira³

et al. 2014

Arquivos Brasileiros De Cardiologia

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BackgroundTranscatheter aortic valve implantation is an effective alternative to surgical treatment of severe aortic stenosis in patients who are inoperable or at high surgical risk.ObjectivesTo report the immediate and follow-up clinical and echocardiographic results of the initial experience of transcatheter aortic valve implantation.MethodsFrom 2009 June to 2013 February, 112 patients underwent transcatheter aortic valve implantation.ResultsMean age was 82.5 ± 6.5 years, and the logistic EuroSCORE was 23.6 ± 13.5. Procedural success was 84%. After the intervention, a reduction in the mean systolic gradient was observed (pre: 54.7 ± 15.3 vs. post: 11.7 ± 4.0 mmHg; p < 0.01). Cerebrovascular accidents occurred in 3.6%, vascular complications in 19% and permanent pacemaker was required by 13% of the patients. Thirty-day mortality and at follow-up of 16 ± 11 months was 14% and 8.9% respectively. The presence of chronic obstructive pulmonary disease was the only predictor of mortality at 30 days and at follow-up. During follow up, aortic valve area and mean systolic gradient did not change significantly.ConclusionsTranscatheter aortic valve implantation is an effective and safe procedure for the treatment of aortic stenosis in high-surgical risk or inoperable patients. The presence of chronic obstructive pulmonary disease was the only independent predictor of mortality identified both in the first month post-intervention and at follow-up.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Initial Experience of Two National Centers in Transcatheter Aortic Prosthesis Implantation

Lluberas¹,

Abizaid²,

Siqueira³

et al. 2014

Arquivos Brasileiros De Cardiologia

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“…A estenose aórtica (EAo) é a doença cardíaca valvar mais comum, afetando, aproximadamente, 3% da população com idade superior a 75 anos. Com o aumento da expectativa de vida da população brasileira, estima-se que em 2030 haverá 11 milhões de brasileiros nessa faixa etária e, como consequência, aproximadamente 350 mil pacientes com EAo degenerativa 1 .…”

Section: Introductionunclassified

Pós-operatório de implante de bioprótese aórtica por cateter: intervenções de enfermagem

Almeida

Grassia

Nascimento³

2015

Rev. Sobecc

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RESUMO: Estenose aórtica (EAo) é a doença cardíaca valvar mais comum, afeta, aproximadamente, 3% da população idosa submetida a implante de bioprótese aórtica por cateter. Os enfermeiros necessitam aperfeiçoar o conhecimento para elaborar protocolos de atendimento e cuidados. Objetivo: propor intervenções de enfermagem no período pós-operatório imediato para pacientes submetidos a tratamento da estenose aórtica por cateter. Método: pesquisa retrospectiva, quantitativa, com amostra composta por 418 pacientes cujos dados foram fornecidos pelo Registro Brasileiro de Implante por Cateter de Bioprótese Valvar Aórtica, entre janeiro de 2008 e fevereiro de 2013. Resultados: a média de idade foi de 81,5 anos, 348 pacientes apresentavam classe funcional III ou IV de insuficiência cardíaca, sendo que as complicações com maior incidência foram: bloqueio de ramo esquerdo (129 pacientes), bloqueio átrio ventricular (110) e necessidade de implante de marca-passo (83). Conclusão: Foram propostas as intervenções de enfermagem para avaliação da função neurológica, vascular, hematológica, renal, cardíaca, parâmetros vitais e controle da dor.Palavras-chave: Estenose da valva aórtica. Implante de prótese de valva cardíaca. Bioprótese. Avaliação em enfermagem. Cuidados pós-operatórios. ABSTRACT: Aortic stenosis (AS) is the most common valvular heart disease; affects approximately 3% of the elderly population, underwent implantation of aortic bioprosthesis catheter. Nurses need to improve knowledge, to develop treatment protocols and care. Objective: Propose nursing interventions for postoperative patients treated for AS catheter. Method: Retrospective, quantitative research; composite sample of the Registro Brasileiro de Implantepor Cateter de Bioprótese Valvar Aórtica, with 418 patients between January 2008 and February 2013. Results: The mean age was 81.5 years, 348 were in functional class III or IV cardiac arrest; complications with the highest incidence: left bundle branch block (129 patients), atrioventricular block (110) and the need for pacemaker implantation (83). Conclusion: We propose the nursing interventions for evaluation of neurological function, vascular, hematologic, renal, cardiac, vital signs, and pain control. Keywords: Aortic valve stenosis. Heart valve prosthesis implantation. Bioprosthesis. Nursing assessment. Postoperative care.RESUMEN: La estenosis aórtica (EA) es la enfermedad valvular cardiaca más común; afecta, aproximadamente, 3% de la población de edad avanzada que se sometió a implantación del cateter bioprótesis aórtica. Hay la necesidad de mejorar el conocimiento de los enfermeros para que puedan desarrollar protocolos de tratamiento y atención. Objetivo: proponer intervenciones de enfermería para el postoperatorio de los pacientes tratados por catéter EA.Método: investigación cuantitativa retrospectiva, con muestra compuesta por 418 pacientes cuyos datos proveen del Registro Brasileiro de Implante por Cateter de Bioprótese Valvar Aórtica, entre enero de 2008 y febrero de 2013. Resultados: la edad med...

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EuroSCORE II and STS as mortality predictors in patients undergoing TAVI

Rosa¹,

Lopes²,

Accorsi³

et al. 2016

Rev. Assoc. Med. Bras.

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SUMMARY Introduction: the EuroSCORE II and STS are the most used scores for surgical risk stratification and indication of transcatheter aortic valve implantation (TAVI). However, its role as a tool for mortality prediction in patients undergoing TAVI is still unclear. Objective: to evaluate the performance of the EuroSCORE II and STS as predictors of in-hospital and 30-day mortality in patients undergoing TAVI. Methods: we included 59 symptomatic patients with severe aortic stenosis that underwent TAVI between 2010 and 2014. The variables were analyzed using Student's t-test and Fisher's exact test and the discriminative power was evaluated using receiver operating characteristic curve (ROC) and area under the curve (AUC) with a 95% confidence interval. Results: mean age was 81±7.3 years, 42.3% men. The mean EuroSCORE II was 7.6±7.3 % and STS was 20.7±10.3%. Transfemoral procedure was performed in 88.13%, transapical in 3.38% and transaortic in 8.47%. In-hospital mortality was 10.1% and 30-day mortality was 13.5%. Patients who died had EuroSCORE II and STS higher than the survivors (33.7±16.7vs. 18.6±7.3% p=0,0001 for STS and 13.9±16.1 vs. 4.8±3.8% p=0.0007 for EuroSCORE II). The STS showed an AUC of 0.81 and the EuroSCORE II of 0.77 and there were no differences in the discrimination ability using ROC curves (p=0.72). Conclusion: in this cohort, the STS and EuroSCORE II were predictors of in-hospital and 30-days mortality in patients with severe aortic stenosis undergoing TAVI.

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Implante por cateter de bioprótese valvar para tratamento da estenose aórtica: experiência de três anos

Abstract: Background: Transcatheter aortic bioprosthesis implantation is a new treatment modality for patients with aortic stenosis who are inoperable or at high surgical risk.

Cited by 4 publications

References 33 publications

Initial Experience of Two National Centers in Transcatheter Aortic Prosthesis Implantation

Initial Experience of Two National Centers in Transcatheter Aortic Prosthesis Implantation

Pós-operatório de implante de bioprótese aórtica por cateter: intervenções de enfermagem

EuroSCORE II and STS as mortality predictors in patients undergoing TAVI

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