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Implante por cateter de bioprótese valvar para tratamento da estenose aórtica: experiência de três anos

DOI: 10.1590/S0066-782X2012005000063

Keywords: aortic valve stenosis, balloon dilatation, heart valve prosthesis.

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Abstract:

background: transcatheter aortic bioprosthesis implantation is a new treatment modality for patients with aortic stenosis who are inoperable or at high surgical risk. objective: to report the three-year experience with transcatheter corevalve? bioprosthesis implantation. methods: from january 2008 to january 2011, 35 patients with aortic stenosis (33) or aortic valve bioprosthesis dysfunction (two) at high surgical risk underwent transcatheter corevalve? bioprosthesis implantation. results: the patients' mean age was 81.5 ± 9 years, and 80% had heart failure functional class iii or iv. the euroscore was 18.4 ± 14.3% and the sts risk score was 14.5 ± 11.6%. successful device implantation was achieved in 34 (97.1%) patients. after the intervention, a reduction in the transvalvular pressure gradient from 84.9 ± 22 to 22.5 ± 9.5 mm hg was observed, and 87.1% of the patients progressed to functional class i or ii. thirty-day mortality and mortality in the follow-up of 400 ± 298 days were 11.4% and 31.4%, respectively. the occurrence of life-threatening hemorrhagic complications was the only independent predictor of cardiovascular mortality. stroke occurred in 5.7% of the patients. permanent pacemaker was required in 32.1% of the patients within the first month after the procedure. conclusion: transcatheter aortic bioprosthesis implantation is a safe and effective procedure to be used in patients with aortic stenosis at high surgical risk. the corevalve? prosthesis proved to have mid-term efficacy in a three-year follow-up.

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