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CPC 2018
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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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CLEAR FILTERS
Rapid deployment valves – Single center experience
Session:
Posters 1 - Écran 04 - Cirurgia Cardíaca
Speaker:
Nádia Junqueira
Congress:
CPC 2018
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
26. Cardiovascular Surgery
Subtheme:
26.2 Cardiovascular Surgery – Valves
Session Type:
Posters
FP Number:
---
Authors:
André Sena; Nádia Viviana Junqueira; Ricardo Ferreira; Maria Joana Silva; Tiago Velho; Hugo Ferreira; Javier Gallego; Ricardo Arruda Pereira ; Ângelo Nobre
Abstract
<p><strong>Background</strong><br /> Aortic valve replacement surgery (AVR) is the gold standard in the treatment of severe aortic valve disease. Rapid deployment aortic valves (RDV) promise a faster and easier implantation procedure, with the consequent benefits of a shorter?extracorporeal circulation, less aorta manipulation and facilitation of minimally invasive procedures. The current study reports our single-center experience regarding the early outcomes with RDV.</p> <p> </p> <p><strong>Methods</strong><br /> Retrospective analysis of the 163 patients who received a RDV (110 Intuity and 53 Perceval valves), in an isolated AVR until September 2017. Preoperative, intraoperative, and postoperative data was obtained. Statistical analysis was performed with the appropriated statistical test for each variable.</p> <p><br /> <br /> <strong>Results</strong><br /> Mean age was 75.8±5.7y old and gender was equally distributed. All patients were symptomatic; the majority had severe aortic stenosis and preserved LV function. The mean Euroscore II was 2.2±1.3. The main comorbidities were arterial hypertension (93.3%), impaired renal function (78.5%), dyslipidemia (77.9%), and overweight / obesity (74.2%). In AVR through full sternotomy, the mean durations of aorta clamping, on pump, and surgery, were respectively, 28.2±8.9, 36.7±11.5, 88.7±28.9 minutes, with Intuity valve (n=103). With Perceval valve, they were 28,1±6,0, 37.4±7.4 and 94.1±13.0 minutes (n=38). The differences were not significant. Post implantation mean gradients were, in average, 8.6±4.3 mmHg (n=30). Mean ICU stay was 3 days and in-department stay was 7 days. The most frequent related complications were: renal function deterioration (53.4%, according to KDIGO criteria), although only 1.8% needed dialytic support; the need for inotropic support >24h (25.8%); de novo atrial fibrillation (26.4%); significant bleeding (20.2%) and need of blood related products (>30%); and pacemaker implantation (12.9%). Despite differences between the two valves, none reached statistical significance. Global mortality was 1.2%.</p> <p><br /> <br /> <strong>Conclusions</strong><br /> RDV are easy and quick to implant, being potentially very useful in complex surgeries, minimally invasive procedures and when less manipulation of the aortic ring and / or ascending aorta is necessary. They are also associated to reduced cross clamping and extracorporeal circulation times. During hospitalization, there were no significant or unexpected complications related to the procedure performed or device implanted, with the exception of a large percentage of pacemaker implantation.</p>
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