Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care Center

Detalhes bibliográficos
Autor(a) principal: Azevedo,Fabiula Schwartz
Data de Publicação: 2018
Outros Autores: Correa,Marcelo Goulart, Paula,Débora Holanda Gonçalves, Felix,Alex dos Santos, Belém,Luciano Herman Juaçaba, Mendes,Ana Paula Chedid, Silva,Valeria Gonçalves, Marques,Bruno Miranda, Monteiro,Andrey José de Oliveira, Weksler,Clara, Colafranceschi,Alexandre Siciliano, Kasal,Daniel Arthur Barata
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Brazilian Journal of Cardiovascular Surgery (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382018000100003
Resumo: Abstract Objective: Transcatheter aortic valve replacement has been an alternative to invasive treatment for symptomatic severe aortic stenosis in high risk patients. The primary endpoint was 30-day and 1-year mortality from any cause. Secondary endpoints were to compare the clinical and echocardiographic variation pre-and post- transcatheter aortic valve replacement, and the occurrence of complications throughout a 4-year follow-up period. Methods: This prospective cohort, nestled to a multicenter study (Registro Brasileiro de Implante de Bioprótese por Cateter), describes the experience of a public tertiary center in transcatheter aortic valve replacement. All patients who underwent this procedure between October 2011 and February 2016 were included. Results: Fifty-eight patients underwent transcatheter aortic valve replacement. The 30-day all-cause mortality was 5.2% (n=3) and after 1 year was 17.2% (n=10). A significant improvement in New York Heart Association functional classification was observed when comparing pre-and post- transcatheter aortic valve replacement (III or IV 84.4% versus 5.8%; P<0.001). A decline in peak was observed (P<0.001) and mean (P<0.001) systolic transaortic gradient. The results of peak and mean post-implant transaortic gradient were sustained after one year (P=0.29 and P=0.36, respectively). Left ventricular ejection fraction did not change significantly during follow-up (P=0.41). The most frequent complications were bleeding (28.9%), the need for permanent pacemaker (27.6%) and acute renal injury (20.6%). Conclusion: Mortality and complications in this study were consistent with worldwide experience. Transcatheter aortic valve replacement had positive clinical and hemodynamic results, when comparing pre-and post-procedure, and the hemodynamic profile of the prosthesis was sustained throughout follow-up.
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spelling Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care CenterTranscatheter Aortic Valve ReplacementHeart Valve Prosthesis ImplantationAortic Valve Stenosis/surgeryAbstract Objective: Transcatheter aortic valve replacement has been an alternative to invasive treatment for symptomatic severe aortic stenosis in high risk patients. The primary endpoint was 30-day and 1-year mortality from any cause. Secondary endpoints were to compare the clinical and echocardiographic variation pre-and post- transcatheter aortic valve replacement, and the occurrence of complications throughout a 4-year follow-up period. Methods: This prospective cohort, nestled to a multicenter study (Registro Brasileiro de Implante de Bioprótese por Cateter), describes the experience of a public tertiary center in transcatheter aortic valve replacement. All patients who underwent this procedure between October 2011 and February 2016 were included. Results: Fifty-eight patients underwent transcatheter aortic valve replacement. The 30-day all-cause mortality was 5.2% (n=3) and after 1 year was 17.2% (n=10). A significant improvement in New York Heart Association functional classification was observed when comparing pre-and post- transcatheter aortic valve replacement (III or IV 84.4% versus 5.8%; P<0.001). A decline in peak was observed (P<0.001) and mean (P<0.001) systolic transaortic gradient. The results of peak and mean post-implant transaortic gradient were sustained after one year (P=0.29 and P=0.36, respectively). Left ventricular ejection fraction did not change significantly during follow-up (P=0.41). The most frequent complications were bleeding (28.9%), the need for permanent pacemaker (27.6%) and acute renal injury (20.6%). Conclusion: Mortality and complications in this study were consistent with worldwide experience. Transcatheter aortic valve replacement had positive clinical and hemodynamic results, when comparing pre-and post-procedure, and the hemodynamic profile of the prosthesis was sustained throughout follow-up.Sociedade Brasileira de Cirurgia Cardiovascular2018-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382018000100003Brazilian Journal of Cardiovascular Surgery v.33 n.1 2018reponame:Brazilian Journal of Cardiovascular Surgery (Online)instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)instacron:SBCCV10.21470/1678-9741-2017-0117info:eu-repo/semantics/openAccessAzevedo,Fabiula SchwartzCorrea,Marcelo GoulartPaula,Débora Holanda GonçalvesFelix,Alex dos SantosBelém,Luciano Herman JuaçabaMendes,Ana Paula ChedidSilva,Valeria GonçalvesMarques,Bruno MirandaMonteiro,Andrey José de OliveiraWeksler,ClaraColafranceschi,Alexandre SicilianoKasal,Daniel Arthur Barataeng2018-03-27T00:00:00Zoai:scielo:S0102-76382018000100003Revistahttp://www.rbccv.org.br/https://old.scielo.br/oai/scielo-oai.php||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br1678-97410102-7638opendoar:2018-03-27T00:00Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)false
dc.title.none.fl_str_mv Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care Center
title Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care Center
spellingShingle Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care Center
Azevedo,Fabiula Schwartz
Transcatheter Aortic Valve Replacement
Heart Valve Prosthesis Implantation
Aortic Valve Stenosis/surgery
title_short Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care Center
title_full Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care Center
title_fullStr Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care Center
title_full_unstemmed Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care Center
title_sort Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care Center
author Azevedo,Fabiula Schwartz
author_facet Azevedo,Fabiula Schwartz
Correa,Marcelo Goulart
Paula,Débora Holanda Gonçalves
Felix,Alex dos Santos
Belém,Luciano Herman Juaçaba
Mendes,Ana Paula Chedid
Silva,Valeria Gonçalves
Marques,Bruno Miranda
Monteiro,Andrey José de Oliveira
Weksler,Clara
Colafranceschi,Alexandre Siciliano
Kasal,Daniel Arthur Barata
author_role author
author2 Correa,Marcelo Goulart
Paula,Débora Holanda Gonçalves
Felix,Alex dos Santos
Belém,Luciano Herman Juaçaba
Mendes,Ana Paula Chedid
Silva,Valeria Gonçalves
Marques,Bruno Miranda
Monteiro,Andrey José de Oliveira
Weksler,Clara
Colafranceschi,Alexandre Siciliano
Kasal,Daniel Arthur Barata
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Azevedo,Fabiula Schwartz
Correa,Marcelo Goulart
Paula,Débora Holanda Gonçalves
Felix,Alex dos Santos
Belém,Luciano Herman Juaçaba
Mendes,Ana Paula Chedid
Silva,Valeria Gonçalves
Marques,Bruno Miranda
Monteiro,Andrey José de Oliveira
Weksler,Clara
Colafranceschi,Alexandre Siciliano
Kasal,Daniel Arthur Barata
dc.subject.por.fl_str_mv Transcatheter Aortic Valve Replacement
Heart Valve Prosthesis Implantation
Aortic Valve Stenosis/surgery
topic Transcatheter Aortic Valve Replacement
Heart Valve Prosthesis Implantation
Aortic Valve Stenosis/surgery
description Abstract Objective: Transcatheter aortic valve replacement has been an alternative to invasive treatment for symptomatic severe aortic stenosis in high risk patients. The primary endpoint was 30-day and 1-year mortality from any cause. Secondary endpoints were to compare the clinical and echocardiographic variation pre-and post- transcatheter aortic valve replacement, and the occurrence of complications throughout a 4-year follow-up period. Methods: This prospective cohort, nestled to a multicenter study (Registro Brasileiro de Implante de Bioprótese por Cateter), describes the experience of a public tertiary center in transcatheter aortic valve replacement. All patients who underwent this procedure between October 2011 and February 2016 were included. Results: Fifty-eight patients underwent transcatheter aortic valve replacement. The 30-day all-cause mortality was 5.2% (n=3) and after 1 year was 17.2% (n=10). A significant improvement in New York Heart Association functional classification was observed when comparing pre-and post- transcatheter aortic valve replacement (III or IV 84.4% versus 5.8%; P<0.001). A decline in peak was observed (P<0.001) and mean (P<0.001) systolic transaortic gradient. The results of peak and mean post-implant transaortic gradient were sustained after one year (P=0.29 and P=0.36, respectively). Left ventricular ejection fraction did not change significantly during follow-up (P=0.41). The most frequent complications were bleeding (28.9%), the need for permanent pacemaker (27.6%) and acute renal injury (20.6%). Conclusion: Mortality and complications in this study were consistent with worldwide experience. Transcatheter aortic valve replacement had positive clinical and hemodynamic results, when comparing pre-and post-procedure, and the hemodynamic profile of the prosthesis was sustained throughout follow-up.
publishDate 2018
dc.date.none.fl_str_mv 2018-02-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382018000100003
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382018000100003
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.21470/1678-9741-2017-0117
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Cirurgia Cardiovascular
publisher.none.fl_str_mv Sociedade Brasileira de Cirurgia Cardiovascular
dc.source.none.fl_str_mv Brazilian Journal of Cardiovascular Surgery v.33 n.1 2018
reponame:Brazilian Journal of Cardiovascular Surgery (Online)
instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
instacron:SBCCV
instname_str Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
instacron_str SBCCV
institution SBCCV
reponame_str Brazilian Journal of Cardiovascular Surgery (Online)
collection Brazilian Journal of Cardiovascular Surgery (Online)
repository.name.fl_str_mv Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
repository.mail.fl_str_mv ||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br
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