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

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Data
2018
Autores
Azevedo, Fabiula Schwartz
Correa, Marcelo Goulart
Paula, Débora Holanda Gonçalves
Felix, Alex dos Santos
Belém, Luciano Herman Juaçaba
Mendes, Ana Paula Chedid
Silva, Valeria Gonçalves
Marques, Bruno Miranda
Monteiro, Andrey José de Oliveira
Weksler, Clara
Journal Title
Journal ISSN
Volume Title
Publisher
Brazilian Journal of Cardiovascular Surgery
Resumo
Objective: Transcatheter 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. Methods: This 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. Results: Fifty-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%). Conclusion: Mortality 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.
Description
Palavras-chave
Transcatheter Aortic Valve Replacement, Heart Valve Prosthesis Implantation, Aortic Valve Stenosis/surgery
Citação
Azevedo FS, Correa MG, Paula DHG, Felix ADS, Belém LHJ, Mendes APC, Silva VG, Marques BM, Monteiro AJO, Weksler C, Colafranceschi AS, Kasal DAB. Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care Center. Braz J Cardiovasc Surg. 2018 Jan-Feb;33(1):1-7. doi: 10.21470/1678-9741-2017-0117.