Arquivos brasileiros de cardiologia · 2014
Initial experience of two national centers in transcatheter aortic prosthesis implantation.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Lluberas Sebastián, Abizaid Alexandre, Siqueira Dimytri, Ramos Auristela, Costa J Ribamar, Arrais Magaly, Kambara Antônio, Bihan David Le, Sousa Amanda, Sousa J Eduardo
Аннотация
BACKGROUND: Transcatheter aortic valve implantation is an effective alternative to surgical treatment of severe aortic stenosis in patients who are inoperable or at high surgical risk.
OBJECTIVES: To report the immediate and follow-up clinical and echocardiographic results of the initial experience of transcatheter aortic valve implantation.
METHODS: From 2009 June to 2013 February, 112 patients underwent transcatheter aortic valve implantation.
RESULTS: Mean 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.
CONCLUSIONS: Transcatheter 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.
OBJECTIVES: To report the immediate and follow-up clinical and echocardiographic results of the initial experience of transcatheter aortic valve implantation.
METHODS: From 2009 June to 2013 February, 112 patients underwent transcatheter aortic valve implantation.
RESULTS: Mean 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.
CONCLUSIONS: Transcatheter 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.
Предметные рубрики MeSH
AgedAged, 80 and overAortic Valve StenosisCardiac CatheterizationEchocardiography, DopplerFemaleFollow-Up StudiesHeart Valve ProsthesisHeart Valve Prosthesis ImplantationHemodynamicsHumansKaplan-Meier EstimateMalePostoperative ComplicationsRisk AssessmentRisk FactorsStatistics, NonparametricStrokeTime FactorsTreatment Outcome