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ISSN 0188-2198 (Impreso)

2018, Número 2

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Rev Mex Cardiol 2018; 29 (2)


TAVI en pacientes de riesgo intermedio: una revisión a propósito de un caso

Escutia-Cuevas HH, Merino-Rajme JA, Alcántara-Meléndez MA, Espinoza-Rueda MA, Fernández-Ceseña E, García-García JF, Morales-Portano JD, Muratalla-González R, Ordoñez-Salazar BA

Idioma: Ingles.
Referencias bibliográficas: 20
Paginas: 102-111
Archivo PDF: 591.08 Kb.


RESUMEN

Antecedentes: La estenosis aórtica es la valvulopatía más común en todo el mundo. El pronóstico es sombrío sin reemplazo valvular. La implantación valvular aórtica transcatéter (TAVI) ha demostrado ser un tratamiento eficaz en pacientes de alto riesgo quirúrgico. Ensayos muy recientes destacaron la no-inferioridad de TAVI en comparación con la cirugía abierta en pacientes con riesgo quirúrgico intermedio. Caso clínico: Se presenta un hombre de 76 años de edad con estenosis aórtica severa y riesgo quirúrgico intermedio (STS-PROM 4.8%), al que se realiza TAVI sin complicaciones. Resultados: El alta hospitalaria se decide cinco días después del procedimiento para continuar el seguimiento ambulatorio. Después de dos años, el seguimiento permanece en la clase funcional I de la NYHA con una prótesis percutánea normofuncional. Conclusión: Como muestra este caso clínico, TAVI ha demostrado ser un tratamiento eficaz en pacientes de riesgo quirúrgico intermedio. Ésta es la primera experiencia en el uso de esta tecnología en este tipo de pacientes reportada en nuestro país.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Iung B, Cachier A, Baron G, Messika-Zeitoun D, Delahaye F, Tornos P et al. Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery? Eur Heart J. 2005; 26 (24): 2714-2720.

  2. Iung B, Baron G, Butchart EG, Delahaye F, Gohlke-Bärwolf C, Levang OW et al. A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease. Eur Heart J. 2003; 24 (13): 1231-1243.

  3. Cribier A, Eltchaninoff H, Bash A, Borenstein N, Tron C, Bauer F et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation. 2002; 106 (24): 3006-3008.

  4. Jansen F, Werner N. Interventional treatment of the aortic valve : Current evidence. Herz. 2017; 42 (6): 548-553.

  5. Rodés-Cabau J, Webb JG, Cheung A, Ye J, Dumont E, Feindel CM et al. Transcatheter aortic valve implantation for the treatment of severe symptomatic aortic stenosis in patients at very high or prohibitive surgical risk: acute and late outcomes of the multicenter Canadian experience. J Am Coll Cardiol. 2010; 55 (11): 1080-1090.

  6. Tamburino C, Capodanno D, Ramondo A, Petronio AS, Ettori F, Santoro G et al. Incidence and predictors of early and late mortality after transcatheter aortic valve implantation in 663 patients with severe aortic stenosis. Circulation. 2011; 123 (3): 299-308.

  7. Thomas M, Schymik G, Walther T, Himbert D, Lefèvre T, Treede H et al. Thirty-day results of the SAPIEN aortic Bioprosthesis European Outcome (SOURCE) Registry: A European registry of transcatheter aortic valve implantation using the Edwards SAPIEN valve. Circulation. 2010; 122 (1): 62-69.

  8. Piazza N, Grube E, Gerckens U, den Heijer P, Linke A, Luha O et al. Procedural and 30-day outcomes following transcatheter aortic valve implantation using the third generation (18 Fr) corevalve revalving system: results from the multicentre, expanded evaluation registry 1-year following CE mark approval. EuroIntervention. 2008; 4 (2): 242-249.

  9. Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010; 363 (17): 1597-1607.

  10. Smith CR, Leon MB, Mack MJ, Miller DC, Moses JW, Svensson LG et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011; 364 (23): 2187-2198.

  11. Leon MB, Smith CR, Mack MJ, Makkar RR, Svensson LG, Kodali SK, Thourani VH et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2016; 374 (17): 1609-1620.

  12. Reardon MJ, Van Mieghem NM, Popma JJ, Kleiman NS, Søndergaard L, Mumtaz M et al. Surgical or transcatheter aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2017; 376 (14): 1321-1331.

  13. Thourani VH, Kodali S, Makkar RR, Herrmann HC, Williams M, Babaliaros V et al. Transcatheter aortic valve replacement versus surgical valve replacement in intermediate-risk patients: a propensity score analysis. Lancet. 2016; 387 (10034): 2218-2225.

  14. Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017; 38 (36): 2739-2791.

  15. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA et al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017; 70 (2): 252-289.

  16. Auffret V, Lefevre T, Van Belle E, Eltchaninoff H, Iung B, Koning R et al. Temporal Trends in Transcatheter Aortic Valve Replacement in France: FRANCE 2 to FRANCE TAVI. J Am Coll Cardiol. 2017; 70 (1): 42-55.

  17. Ali N, Patel PA, Lindsay SJ. Recent developments and controversies in transcatheter aortic valve implantation. Eur J Heart Fail. 2018; 20 (4): 642-650.

  18. Barbanti M, Capranzano P, Ohno Y, Attizzani GF, Gulino S, Immè S, Cannata S et al. Early discharge after transfemoral transcatheter aortic valve implantation. Heart. 2015; 101 (18): 1485-1490.

  19. Urena M, Hayek S, Cheema AN, Serra V, Amat-Santos IJ, Nombela-Franco L et al. Arrhythmia burden in elderly patients with severe aortic stenosis as determined by continuous electrocardiographic recording: toward a better understanding of arrhythmic events after transcatheter aortic valve replacement. Circulation. 2015; 131 (5): 469-477.

  20. Barbanti M, Gulino S, Costa G, Tamburino C. Pathophysiology, incidence and predictors of conduction disturbances during Transcatheter Aortic Valve Implantation. Expert Rev Med Devices. 2017; 14 (2): 135-147.




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