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CPC 2019
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
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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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Valve-in-valve implantation in degenerative aortic bioprosthesis. The current standard?
Session:
Posters 2 - Écran 2 - Doença Valvular
Speaker:
Mariana Gonçalves
Congress:
CPC 2019
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.4 Valvular Heart Disease – Treatment
Session Type:
Posters
FP Number:
---
Authors:
Mariana Gonçalves; Rui Campante Teles; Bruno Rocha; Afonso Félix De Oliveira; Catarina Brízido; João Brito; Tiago Nolasco; Pedro de Araújo Gonçalves; Luís Raposo ; Henrique Gabriel; Manuel Almeida; José Pedro Neves; Miguel Mendes
Abstract
<p><strong>Background</strong>: Valve-in-valve (VinV) procedural success usually requires a different approach compared to regular transcatether aortic valvular implants (TAVI) .</p> <p> </p> <p><strong>Aim:</strong> To evaluate the contemporary safety and efficacy of V-in-V procedures.</p> <p> </p> <p><strong>Methods: </strong>Longitudinal prospective registry including 17 consecutive patients with failing bioprosthesis since 2010 to 2018, mean age 80.4 ± 7.1 years, median LVEF 60% ±6 IQR , median STS 4.7% ±2.2 IQR. Failed valves were 8 Mitroflow (4 nº19 and 3 nº21 and 1 nº23), 4 Epic (1 nº 21 and 3 nº 23), 3 homografts, 1 Mosaic nº23 and 1 Perimount nº25. The failure mechanism was mainly stenosis in 47%, mixed in 29% and regurgitation in 24%. VinV was performed with Corevalve in 94% of the cases, all by transfemoral route. Median length of stay was 7 days ±16 IQR. The primary objective was the VARC-2 device success definition and the secondary endpoints were 1-year mortality and VARC-2 events.</p> <p><strong>Results: </strong> Procedural success was 71% (12/17): no mortality, 3 procedures with residual gradients > 20mmHg (Mitroflow 19 and 21), 3 VinV with regurgitation ≥ moderate (2 homografts and 1 Epic 23).</p> <p>At 30 days, mortality occurred in 5,9% (1/17), successful PCI with preventive guidewire for acute coronary occlusion in 5,9% (1/17), new pacemaker insertion in 8,3% (1/12) and type 2 BARC criteria hemorrhage in 5,9% (1/17). At 1-year total mortality was 11,8% (2/17) and improvement in NYHA grade occurred in 80% (12/15) patients.</p> <p> </p> <p><strong>Conclusions: </strong>Transcatheter aortic valve-in-valve implantation was feasible and safe, albeit the rate of moderate paravalvular leak. This technique might become the first line therapy in a large range of degenerative aortic bioprosthesis.</p>
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