Implante transcateter de valva aórtica

Gaia, Diego Felipe; Palma, José Honório; Ferreira, Carolina Baeta Neves Duarte; Souza, José Augusto Marcondes de; Gimenes, Marcus Vinícius; Macedo, Murilo Teixeira; Martins, Márcio Rodrigo; Buffolo, Ênio

doi:10.5935/1678-9741.20110007

Cited by 17 publications

(3 citation statements)

References 22 publications

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“…In cases of dysfunctional aortic bioprosthesis, conventional valve replacement is associated with higher risk compared to the first cardiac surgery and may contraindicate the surgery intervention [ 13 ] . Valve-in-valve has shown as a safe alternative and has shown adequate hemodynamic performance [ 14 , 15 ] . In this cohort, valve-in-valve procedures were not analyzed apart and can interfere on results, mainly on transaortic gradients.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care Center

Azevedo

Correa

Paula

et al. 2018

Braz J Cardiovasc Surg

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ObjectiveTranscatheter aortic valve replacement has been an alternative to invasive treatment for symptomatic severe aortic stenosis in high risk patients. The primary endpoint was 30-day and 1-year mortality from any cause. Secondary endpoints were to compare the clinical and echocardiographic variation pre-and post- transcatheter aortic valve replacement, and the occurrence of complications throughout a 4-year follow-up period.MethodsThis prospective cohort, nestled to a multicenter study (Registro Brasileiro de Implante de Bioprótese por Cateter), describes the experience of a public tertiary center in transcatheter aortic valve replacement. All patients who underwent this procedure between October 2011 and February 2016 were included.ResultsFifty-eight patients underwent transcatheter aortic valve replacement. The 30-day all-cause mortality was 5.2% (n=3) and after 1 year was 17.2% (n=10). A significant improvement in New York Heart Association functional classification was observed when comparing pre-and post- transcatheter aortic valve replacement (III or IV 84.4% versus 5.8%; P<0.001). A decline in peak was observed (P<0.001) and mean (P<0.001) systolic transaortic gradient. The results of peak and mean post-implant transaortic gradient were sustained after one year (P=0.29 and P=0.36, respectively). Left ventricular ejection fraction did not change significantly during follow-up (P=0.41). The most frequent complications were bleeding (28.9%), the need for permanent pacemaker (27.6%) and acute renal injury (20.6%).ConclusionMortality and complications in this study were consistent with worldwide experience. Transcatheter aortic valve replacement had positive clinical and hemodynamic results, when comparing pre-and post-procedure, and the hemodynamic profile of the prosthesis was sustained throughout follow-up.

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Section: Discussionmentioning

confidence: 99%

Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care Center

Azevedo

Correa

Paula

et al. 2018

Braz J Cardiovasc Surg

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“…Transapical approach of the heart has been shown as an excellent alternative in minimally invasive procedures and high risk patients, who present with severe cardiovascular diseases, older age and other systemic disorders associated [ 16 , 17 ] . In this group, there are patients with heart valve diseases, aortic aneurysms and dissections, congestive heart failure and other infirmities, who will directly benefit from the development of a device that enables such approach in a safer manner, with less risk of complications, bleeding, ventricular rupture and also facilitates posterior interventions.…”

Section: Discussionmentioning

confidence: 99%

A New Experimental Device for Transapical Access of the Aortic and Mitral Valves as well as the Aorta in its Various Segments

Paim¹,

Fonseca²,

Arruda³

et al. 2017

Braz J Cardiovasc Surg

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ObjectiveTo present the results of a new experimental device developed to facilitate the transapical access in endovascular treatment of structural heart diseases. It aims to reduce the risk of bleeding and complications in this type of access and demonstrate the device as a safe, fast and effective alternative.MethodsCorPoint is composed of three parts: introducer, base with coiled spring, and closing capsule. By rotating movements, the spring is introduced into the myocardium and progressively approaches the base to the surface of the heart. Guidewires and catheters are inserted through the hollow central part and, at the end of the procedure, the capsule is screwed over the base, therefore stopping any bleeding.ResultsThe device was implanted in 15 pigs, weighing 60 kg each, through an anterolateral thoracotomy, while catheters were introduced and guided by fluoroscopy. All animals had minimal bleeding; introducers with diameter up to 22 Fr were used and various catheters and guidewires were easily handled. After finishing the procedure, the closing capsule was attached and no bleeding was observed at the site.ConclusionThis new device has proved effective, fast and secure for the transapical access. This shows great potential for use, especially by ensuring an easier and direct access to the mitral and aortic valves; the shortest distance to be traveled by catheters; access to the ascending and descending aorta; decreased bleeding complications; decreased surgical time; and the possibility of allowing the technique to evolve and become totally percutaneous.

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“…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%

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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Implante transcateter de valva aórtica

Abstract: Rev Bras Cir Cardiovasc 2011;26(3):338-47

Cited by 17 publications

References 22 publications

Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care Center

Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care Center

A New Experimental Device for Transapical Access of the Aortic and Mitral Valves as well as the Aorta in its Various Segments

Initial Experience of Two National Centers in Transcatheter Aortic Prosthesis Implantation

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