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