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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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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
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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
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Percutaneous Paravalvular leak percutaneous occlusion – a small gap to a big problem
Session:
Posters 1 - Écran 6 - Cardiologia de Intervenção
Speaker:
Luís Puga
Congress:
CPC 2019
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Posters
FP Number:
---
Authors:
Luís Puga; Rogerio Teixeira; Joana M. Ribeiro; Luis Paiva; João Gameiro; José Pedro Sousa; Diana Decampos; Carolina Saleiro; Alexandrina Siserman; Liliana Reis; Marco Costa; Lino Gonçalves
Abstract
<p><strong>Background</strong>: Paravalvular leak following heart valve replacement surgery often cause significant morbidity and mortality. Anaemia and heart failure (HF) are the most frequent indications for percutaneous paravalvular leak occlusion (PPVLO), although anaemia has a multifactorial aetiology (hemolysis, chronic kidney failure, iron depletion, chronic disease, etc.). </p> <p><strong>Purpose</strong>: To study the clinical outcome of percutaneous paravalvular leak closure focusing on anaemia and HF functional status. </p> <p><strong>Methods</strong>: Single-centre retrospective cohort study consisting of consecutive patients submitted to PPVLO from 2012 to 2018. Haemoglobin levels, NYHA class, and haemolysis were compared before and after procedure. The sample was further divided in groups A (with procedural success) and B (without procedural success) to compare improvement in NYHA class and haemoglobin levels. Haemoglobin improvement was defined as at least 1 g/dL of haemoglobin improvement at least 90 days after the procedure.</p> <p><strong>Results</strong>: 26 PPVLO were performed in our centre from 2012 to 2018. The sample consisted of 20 (77%) females and had a mean age of 67±8 years old. Anaemia was present in 23 (88%) patients with intravascular haemolysis in 13 (50%). Baseline mean haemoglobin level was 10.5±1.9 g/dl. Median NYHA class was 3. NYHA classes 2, 3 and 4 were observed in 6 (23%), 14 (54%) and 6 (23%) respectively. Procedural success was achieved in 65%. Median NYHA class improvement was higher in patients with procedural success (A 10/14, 71% vs B 0/7 0%, <em>P</em>value<0.01). Increases in haemoglobin levels were seen in 14 (54%) patients, although no significant rise in mean haemoglobin levels after the procedure was recorded (10.7±2 vs 11.0±2 g/dl, <em>P </em>value=0.345). Change in haemoglobin was not associated with procedural success (A 9/14 (64%) vs B 5/6 (83%), <em>P</em>value 0.394). Moreover, haemoglobin improvement was not predictor of HF functional recovery assessed a logistic regression method (OR 0.833 95% CI 0.09 – 7.675).</p> <p><strong>Conclusions</strong>: In our sample HF functional recovery was observed following a successful PPVLO. Although it is a frequent referral indication, anaemia status was not associated with procedural success in contrast to HF.</p>
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