Beruflich Dokumente
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A cirurgia cardaca para a troca de prteses cardacas degeneradas est associada a um risco
aumentado, particularmente em doentes idosos com comorbidades.
A cirurgia de implante de prtese valvar cardaca, com taxa de mortalidade em torno de 3,2%,
considerada de alto risco em mais de 30% dos idosos com estenose artica que, por isso, ficam sem
tratamento.
Jaussaud NGV, Giorgi R, Grisoli D, Chalvignac V, Thuny F, Riberi A, Collart F. Risk of reoperation
for aortic bioprosthesis dysfunction. J Heart Valve Dis. 2009;18:256 261.
Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr, Faxon DP, Freed MD, Gaasch WH, Lytle BW,
Nishimura RA, OGara PT, ORourke RA, Otto CM, Shah PM, Shanewise JS. 2008 focused update
incorporated into the acc/aha 2006 guidelines for the management of patients with valvular heart
disease: A report of the American College of Cardiology/American Heart Association Task Force
on Practice Guidelines. J Am Coll Cardiol. 2008;52:e1 e142
The Society of Thoracic Surgeons risk calculator predicts that an 80-year-old man with no
comorbidities has an approximate mortality risk of 5% for aortic reoperation and 10% for mitral
reoperation and a major morbidity risk of 20% and 23%, respectively. These risks increase
dramatically in the presence of comorbidities.
Walther T, Falk V, Dewey T, Kempfert J, Emrich F, Pfannmuller BBP, Borger MA, Schuler G, Mack
M, Mohr FW. Valve-in-a-valve concept for transcatheter minimally invasive repeat xenograft
implantation. J Am Coll Cardiol. 2007;50:56 60.
Webb JG. Transcatheter valve in valve implants for failed prosthetic valves. Catheter Cardiovasc
Interv. 2007;70:765766
Transcatheter heart valve (THV) implantation has found rapid acceptance as an alternative to
conventional surgical valve replacement for patients with native aortic valve stenosis. THV
implantation might also represent an attractive option for patients with failing bioprosthetic valves.
A implantao de Valva cardaca via transcateter (THV) uma rpida alternativa para a cirurgia
convencional de substituio de valva para pacientes com estenose valvar artica. A THV tambm
muito atrativa para pacientes com falha da valva bioprottica.
DIAS, Ricardo Ribeiro et al. Cirurgia da valva artica: estudo prospectivo e randomizado da
miniesternotomia versus cirurgia convencional. Rev. bras. cir. cardiovasc, v. 14, n. 2, p. 98-104,
1999.
DIAS, Ricardo Ribeiro et al. Cirurgia da valva artica: estudo prospectivo e randomizado da
miniesternotomia versus cirurgia convencional. Rev. bras. cir. cardiovasc, v. 14, n. 2, p. 98-104,
1999.
Em funo dos resultados bastante semelhantes, pode-se concluir que a cirurgia minimamente
invasiva para a operao da valva artica apresenta melhor efeito esttico que a cirurgia
convencional, em funo de inciso cirrgica menor.
NISHIMURA, Rick A. et al. Mitral valve diseasecurrent management and future challenges. The
Lancet, v. 387, n. 10025, p. 1324-1334, 2016.
Treatment of even asymptomatic patients with severe mitral regurgitation in valve reference
centres that have high success for repairs and low surgical mortality should be patients expectations
during the next 5 years. Transcatheter mitral valve repair with MitraClip is also producing excellent
outcomes in patients who are of high surgical risk. Clinical trials of MitraClip versus surgery in
intermediate risk patients should be expected to begin in the next few years.
In patients with secondary mitral regurgitation, the vision for the next 5 years is not as clear.
Edwards FH, Peterson ED, Coombs LP, DeLong ER, Jamieson WR, Shroyer AL, et al. Prediction of
operative mortality after valve replacement surgery. J Am Coll Cardiol. 2001;37(3):885-92
GAIA, Diego Felipe et al. Implante transapical de valva artica: resultados de uma nova prtese
brasileira. Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular
Surgery, v. 25, n. 3, p. 293-302, 2010.