Implante transapical de valva aórtica: resultados de uma nova prótese brasileira

Abstract

Objective: The aortic valve replacement is a routine procedure with acceptable risk, but in some cases, such a risk can justify contraindication. The minimally invasive transcatheter aortic valve implantation has been viable, with lower morbidity and mortality. The aim of this study was to develop a national catheter-mounted aortic bioprosthesis for the aortic position implant.Methods: After animal studies, 14 patients with high EuroSCORE underwent transcatheter aortic valve implantation. Median Logistic EuroSCORE was 43.7%. Four patients presented with dysfunctional bioprosthesis, remaining ones presented calcified aortic stenosis. All patients presented symptoms. Procedures were performed in a hybrid OR under fluoroscopic and echocardiography guidance. Using a left minithoracotomy the prosthesis was implanted through the ventricular apex under ventricular pacing or hemorrhagic shock, after aortic valvoplasty. Echocardiograph and angiograph controls were performed, and the patients were referred to ICU.Results: Implant was feasible in 13 cases. There were no intra-operative deaths. Rev Bras Cir Cardiovasc 2010; 25(3): 293-302 treatment. The survival rate with the technique was not satisfactory with a mortality rate of 65% at 1 year. Only 40% of patients at 1 year were free of reintervention, aortic valve replacement surgery, heart block, or death [6]. 294 GAIA, DF ET AL -Transapical aortic valve implantation: results of a Brazilian prosthesis

Minimally invasive aortic valve replacement: an alternative to the conventional technique

“…Transthoracic defibrillation pads were placed in the left, anterior and posterior thoracic region. 6. CPB was set up in a conventional manner, testing the vacuum system through a negative pressure gauge connected to the oxygenator venous reservoir.…”

Pioneering transcatheter aortic valve Implant (Inovare®) via transfemoral

“…In our environment Gaia et al 6 reported a 30-day mortality found in 18.18% and overall mortality (42.42%) mainly attributed to infectious complications postoperatively. The fact that 39.39% of these patients underwent surgery in the presence of decomposition and prolonged hospitalization, induces a greater risk of colonization and infection.…”

Results of aortic valve surgery in patients over 75 years old, at 4.5 years of follow-up

“…Aiming precisely or very elderly patients with high surgical risk, there has been the alternative of percutaneous aortic bioprosthesis method feasible, safe and highly effective in this subgroup of patients [23][24][25][26][27].…”