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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
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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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TAVI: real life results
Session:
Posters 5 - Écran 8 - Doença Valvular
Speaker:
Sara Couto Pereira
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:
Sara Couto Pereira; Miguel Nobre Menezes; P. Carrilho Ferreira; Claudia Jorge; E. Infante de Oliveira; Joana Rigueira; Inês Aguiar Ricardo; Afonso Nunes Ferreira; Tiago Graça Rodrigues; Joana Brito; Paula Campos; Fausto José Pinto; Pedro Canas Da Silva
Abstract
<p><strong>Introduction:</strong> Transcatheter aortic valve implantation (TAVI) is a less invasive alternative to surgical aorthic valve replacement of particular interest in patients with moderate to high surgical risk.</p> <p><strong>Objective:</strong> Our study intends to present the results of TAVI in a high-volume center.</p> <p><strong>Methods:</strong> We performed a retrospective unicentric study of patients consecutively submitted to TAVI from September 2012 to October 2018. Demographic, clinical, imagiological (echocardiographic and coronary computer tomography angiographic) data, procedure characteristics and patient outcomes were analised.</p> <p><strong>Results:</strong> During the period, 440 patients were submited to TAVI (median age 81±7,1 years, 55% women). The most frequent comorbid conditions were coronary heart disease (35.2%; 28% had previous percutaneous angioplasty and 7% previous surgical revascularization), diabetes mellitus (29%) and chronic kidney disease (27.9%). The median EuroScore II was 4.53±3.8% and STS de 6.4±5.3%. Left bundle branch block was present in 14.8% of the patients previously to the procedure.</p> <p>Severe aortic stenosis (95.6%) was the most frequent indication, followed by aortic regurgitation (2.5%). Some patients (1.6%) had disfunction of the previous prosthetic valve and were submitted to valve-in-valve TAVI. The mean left ventricular ejection fraction of the left vetricle was 56.5±11.9%, with a mean gradient of 49.8±14.2% and a mean aortic valve area of 0.66±0.34cm2.</p> <p>The most frequent approach was transfemoral (94,3%), followed by transapical (4.5%). One patient was submitted to transaortic procedure. Sapien® (60.2%) and CoreValve® (36.1%) were the most implanted prostheses. We observed 30-day and 1-year mortality-rates of 4% (n=19) and 10% (n=44), respectively. Five patients died during the procedure. The overall mortality rate was 29% (n=129, mean follow-up 660±692 days).</p> <p>The following complications (and respective relative frequency) were documented: haemorrhage (18.6% - 3% life threatening, 5% major and 10.6% minor), acute kidney injury (37.3% - 5% with AKIN classification ≥2), stroke/transient ischemic attack (3.6%, of which 8 patients with major stroke, 6 with incapacitant sequelae), vascular complications (17.5%, 5% major). One patient suffered peri-procedure acute myocardial infarction and 18.9% needed pacemaker implantation after the intervention. Only one patient presented severe periprosthetic leak on 2-year follow-up echocardiogram, moderate leaks being present in 2.3% of the cases We observed no significant raise in the transprothesic gradients during the follow-up. </p> <p><strong>Conclusion: </strong>We observed inferior complication rates when compared to those described in the literature. Our findings reinforce the safety and effectiveness of TAVI.</p>
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