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Valvular Aórtico en Pacientes de Riesgo Intermedio: Resultados Quirúrgicos - Archivo PPCT

Reemplazo Valvular Aórtico en Pacientes de Riesgo Intermedio: Resultados Quirúrgicos;
Aortic Valve Replacement in Intermediate Risk Patients: Surgical Outcomes

Creators:Fortunato, German Alberto; Cirugía Cardiovascular. Hospital Italiano de Buenos Aires., Marenchino, Ricardo G., Cirio, Sebastián, Rossi, Emiliano, Domenech, Alberto, Kotowicz, Vadim
2018-06-26

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Descripción

Introducción: La cirugía convencional para la enfermedad valvular aórtica continúa siendo el estándar de oro con resultados muy adecuados con relación al riesgo preoperatorio que presenta. El uso de las válvulas transcatéter para el tratamiento de la estenosis aórtica (EAO) ha crecido exponencialmente y se postula para pacientes de riesgo intermedio (RI). En nuestro medio es infrecuente el hallazgo de resultados de la cirugía en este grupo en particular, por lo que presentamos la casuística en nuestro “mundo real”. Objetivos: Complicaciones tempranas en pacientes sometidos a reemplazo valvular aórtico (RVA) con RI preoperatorio de mortalidad (STS PROM% 4%-8%). Material y métodos: Análisis retrospectivo de pacientes sometidos a RVA desde enero de 2007 hasta marzo de 2017. Se realizaron 877 RVA aislados o asociados a cirugía de revascularización miocárdica (CRM). Fueron incluidospacientes con EAO grave, insuficiencia aórtica grave, endocarditis y con STS PROM de 4% a 8%. Fueron excluidos los pacientes de bajo y alto riesgo (STS PROM% &lt; 4% o &gt; 8%), cirugía valvular doble, o cirugías asociadas excepto CRM o ampliación del anillo aórtico. Resultados: Fue incluido un total de 97 pacientes. La edad media fue de 79,4 ± 6,18, y 60,82% de sexo masculino. La mediana de STS PROM% fue de 5,1 (4,4-6). En el 62,9% se realizó CRM. No se registraron casos de fuga paravalvular moderado-grave. La mortalidad a los 30 días fuede 5,1%. Las complicaciones fueron 3,1% de ACV isquémico, 4,1% requerimiento de MCP definitivo y 4,1% por reexploración por sangrado. La estadía hospitalaria total fue de 8 días (6-14). Conclusiones: Los pacientes de RI presentaron resultados acordes con los esperados en términos de morbimortalidad posoperatoria.

Background: Conventional surgery still represents the gold standard therapeutic strategy for aortic valve disease with adequate outcomes according to the operative risk. The use of transcatheter aortic valve implantation (TAVI) for the treatment of aortic stenosis (AS), use has dramatically increased and is being considered for intermediate risk (IR) patients. As the information about the outcomes of surgical aortic valve replacement (AVR) in this particular group of patients is uncommon in our environment, we present the results in our “real world”. Objectives: The aim of our study is to report the rate of early complications of AVR in IR patients (STS PROM% 4%-8%). Methods: We conducted a retrospective analysis of the patients undergoing surgical AVR between January 2007 and March 2017. A total of 877 of isolated AVR procedures or associated with coronary artery bypass graft surgery (CABGS) were performed. Patients with severe AS, severe aortic regurgitation (AR), endocarditis and STS PROM 4%-8% were included. Patients at low surgical risk (STS PROM &lt; 4%), high surgical risk (STS PROM &gt; 8%), double valve surgery or associated procedures (except for CABGS or aortic annular enlargement) were excluded. Results: A total of 97 patients were included. Mean age was 79.4 ± 6.18, and 60.82% were men. Median STS PROM was 5.1% (4.4-6) and 62.9% underwent CABGS. No cases of moderate or severe paravalvular leak were reported. Mortality at 30 days was 5.1%. The following complications were reported: ischemic stroke (3.1%), requirement of definite pacemaker (4.1%) and reoperation due to bleeding (4.1%). Total hospital stay was 8 days (6-14). Conclusions: The results in IR patients were consistent with those expected in terms of postoperative morbidity and mortality.

Metadatos destacados

Colecciones
Argentine Journal of Cardiology

Editor

Sociedad Argentina de Cardiología

Fuente

Revista Argentina de Cardiología; Vol 86, No 2 (2018); 116-120, Argentine Journal of Cardiology; Vol 86, No 2 (2018); 116-120

Citación

Fortunato, German Alberto; Cirugía Cardiovascular. Hospital Italiano de Buenos Aires. et al., “Reemplazo Valvular Aórtico en Pacientes de Riesgo Intermedio: Resultados Quirúrgicos,” Archivo PPCT, consulta 2 de abril de 2026, http://archivoppct.caicyt.gov.ar/items/show/9385.

Dublin Core

Materia

Autor

Fortunato, German Alberto; Cirugía Cardiovascular. Hospital Italiano de Buenos Aires.
Marenchino, Ricardo G.
Cirio, Sebastián
Rossi, Emiliano
Domenech, Alberto
Kotowicz, Vadim

Fuente

Revista Argentina de Cardiología; Vol 86, No 2 (2018); 116-120
Argentine Journal of Cardiology; Vol 86, No 2 (2018); 116-120

Editor

Sociedad Argentina de Cardiología

Fecha

2018-06-26

Derechos

Los que firman al pié, certificamos que tenemos total responsabilidad por la conducción de este estudio y por el diseño y la interpretación de los datos. Nosotros escribimos el manuscrito y somos responsables por la decisión acerca del mismo. Cada uno de nosotros cumple la definición de autor como se afirma en el Comité Internacional de Editores de Revistas Médicas (International Committee of Medical Journal Editors, ver www.icmje.org). Nosotros hemos visto y aprobado el manuscrito final. Ni el artículo, ni ninguna parte esencial del mismo, incluido las tablas y las figuras, será publicado o admitido para arbitrar a otra parte antes de aparecer en la Revista.También notificamos haber leído la sección “conflicto de intereses”, y revelaríamos cualquiera que existiera. Dejamos constancia que si nuestro artículo se publicara en la RAC, cederíamos los derechos (copyright) a la Revista.Los documentos publicados en esta revista están bajo la licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.
Those signing below certify that we have full responsibility for the conduction of this study and for the design and interpretation of the information. We wrote the manuscript and are responsible for its decision. Each of us fulfills the definition of authorship as stated by the International Committee of Medical Journal Editors ( www.icmje.org). We have signed and approved the final manuscript. Neither the manuscript, nor any essential part thereof, including tables and figures, will be published or accepted for refereeing elsewhere before being published in the Journal. We have also read the "Conflict of Interest" section and would disclose any existing. We state that if our manuscript is published in the RAC, we shall transfer the copyright to the Journal.

Formato

Idioma

spa
eng

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info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion