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2022, Número 4

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Cardiovasc Metab Sci 2022; 33 (4)


Regurgitación mitral grado 2+ después de la reparación valvular mitral transcatéter borde a borde: ¿un gran fracaso?

García-Villarreal OA

Idioma: Inglés [English version]
Referencias bibliográficas: 26
Paginas: 181-186
Archivo PDF: 217.61 Kb.


RESUMEN

La cirugía cardiaca y la cardiología intervencionista han estado persiguiendo conjuntamente la idea de trabajar juntos para construir un progreso crítico destinado a nuestros pacientes, a partir de lo cual estamos obligados a rendir cuentas de nuestros resultados a largo plazo. Todo lo anterior está orientado a evitar promesas poco realistas y medidas prácticas que no logran resolver el problema principal. En este punto, surge de nuevo la misma antigua pregunta sobre la eficacia de la reparación mitral borde a borde transcatéter (TEER) en el tratamiento de la insuficiencia mitral funcional (IMF) o primaria. Un punto crítico y de inflexión es la insuficiencia mitral (IM) residual o recurrente después del procedimiento sin anuloplastia. Se debe enfatizar el impacto que ésta tiene en relación con las tasas de supervivencia, mortalidad y rehospitalización por falla cardiaca del paciente, antes de hacer algunas suposiciones especiales. Aproximadamente casi la mitad de los pacientes después de TEER tenían IM 2+ (grado 2/4 por ecocardiografía) dentro del primer año. De hecho, lo anterior ha sido ignorado en gran medida en las guías actuales para la enfermedad cardiaca valvular, dando una clase de recomendación IIa para TEER en IMF o primaria. Por lo tanto, si la IM 2+ después de TEER afecta o no el resultado del paciente debe revisarse nuevamente, así como su impacto en la clase de recomendación para TEER en las actuales guías clínicas.


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