Assuntos
Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/cirurgia , Átrios do Coração , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Ecocardiografia Transesofagiana , Endocardite Bacteriana/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/microbiologia , Insuficiência da Valva Mitral/microbiologia , Streptococcus agalactiae/isolamento & purificação , Resultado do TratamentoAssuntos
Implante de Prótese de Valva Cardíaca , Garantia da Qualidade dos Cuidados de Saúde , Estenose da Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Implante de Prótese de Valva Cardíaca/normas , Humanos , Avaliação de Resultados em Cuidados de Saúde , Stents , Terapias em EstudoRESUMO
BACKGROUND: Short-term results are presented from our first year of experience with transcatheter aortic-valve implantation [corrected] (TAVI) at the University Hospital of North Norway. MATERIALS AND METHODS: TAVI was used to treat 25 patients with aortic stenosis [corrected] from September 2008 to August 2009. 25 patients operated with conventional aortic valve replacement (AVR) served as controls. RESULTS: The TAVI group had a significantly higher EuroSCORE (p < 0.001) than the AVR group. No patients in the TAVI group were treated in the intensive care unit while those in the AVR group received 38 days of intensive care in total. The TAVI group had shorter operating times (p < 0.001), larger mean valve sizes (p < 0.001) and significantly fewer postoperative transfusions (p < 0.001) than the ACR group. Peri-operative stroke and myocardial infarction did not occur in the TAVI group while there was one incidence of stroke and one myocardial infarction in the AVR group. The postoperative transvalvular mean gradient decreased in both groups (p < 0.001) and was significantly lower in the TAVI group (p = 0.001). The NYHA class improved significantly in the TAVI group (p < 0.001). No patients needed implantation of a permanent pacemaker. 30-day mortality was four patients in the AVR group and one patient in the TAVI group. After discharge one patient died in each group. INTERPRETATION: TAVI is safe and effective for selected patients with aortic stenosis [corrected] who are assessed as high risk for AVR. Long-term results are needed and will be decisive for use of this approach in the future.
Assuntos
Estenose da Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Idoso , Idoso de 80 Anos ou mais , Estenose da Valva Aórtica/diagnóstico , Cateterismo Cardíaco , Cateterismo , Eletrocardiografia , Feminino , Seguimentos , Próteses Valvulares Cardíacas , Implante de Prótese de Valva Cardíaca/efeitos adversos , Implante de Prótese de Valva Cardíaca/normas , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos , Avaliação de Resultados em Cuidados de Saúde , Seleção de Pacientes , Desenho de Prótese , Terapias em Estudo , Resultado do TratamentoRESUMO
Our new double patch technique for repairing posteroinferior ventricular septal ruptures (VSRs) offers placement of patches in both the left and right ventricle, avoids ventriculotomies and gives good access and complete control of both AV-valves during implantation. We have treated two patients with this technique. Both survived with unremarkable status upon leaving the hospital.
