Abordagens contemporâneas no tratamento da estenose aórtica
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Jul 23, 2023
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Resumo
Objetivo: Examinar as evidências disponíveis sobre as abordagens na estenose aórtica, incluindo a substituição valvar aórtica transcateter e a cirurgia valvar aórtica minimamente invasiva. Métodos: Trata-se de um estudo de revisão integrativa. As bases de dados utilizadas foram o PubMed e BVS. A busca pelos artigos foi realizada considerando os descritores “Transcatheter Aortic Valve Replacement”, “Aortic Valve Stenosis” e “Cardiovascular Surgical Procedures”, utilizando o operador booleano “AND”. Foram incluídos artigos publicados entre 2022-2023; em inglês; de acesso livre; do tipo estudo clínico, ensaio clínico, estudo observacional e ensaio clínico controlado. Resultados: Dos artigos analisados, vinte abordaram os benefícios e resultados positivos da TAVR. Esses estudos destacaram taxas de mortalidade reduzidas, bons resultados a curto e longo prazo e o TAVR como uma opção custo-efetiva. Entretanto, nove artigos discutiram as complicações e desafios associados ao TAVI. Problemas como desajuste prótese-paciente, anormalidades de condução, lesões renais agudas e distúrbios de coagulação. Ademais, três artigos relataram um benefício significativo quando utilizada a cirurgia convencional em pacientes obesos e pacientes com disfunção ventricular esquerda. Considerações finais: A TAVR é segura e eficaz, com baixa taxa de mortalidade. Por outro lado, a MIARV visa preservar e reparar a valva nativa oferecendo menor risco de complicações.
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Como Citar
Medeiros FilhoA., CordeiroA. de M., SilvaF. P. P., JunqueiraJ. de P. C., SouzaL. do N., AbreuN. T. da S., SantanaP. M. de, AzevedoP. H. B. B. G. de, NóbregaT. S., & RibeiroM. L. J. (2023). Abordagens contemporâneas no tratamento da estenose aórtica. Revista Eletrônica Acervo Médico, 23(7), e13372. https://doi.org/10.25248/reamed.e13372.2023
Seção
Revisão Bibliográfica
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Referências
1. AIDIETIS A, et al. 30-Day and 1-Year Outcomes With HYDRA Self-Expanding Transcatheter Aortic Valve: The Hydra CE Study. JACC Cardiovasc Interv, 2022; 15(1): 93–104.
2. ALASNAG M, et al. One-Year Outcomes for Patients Undergoing Transcatheter Aortic Valve Replacement: The Gulf TAVR Registry. Cardiovasc Revasc Med, 2022; 41: 19–26.
3. BAUMGARTNER H, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. European Heart Journal, 2017; 38(36): 2739–2791.
4. CHEN CG, et al. Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Low-risk Patients: A Meta-Analysis Based on a 2-Year Follow-Up. Anatol J Cardiol, 2022; 26(11): 802–809.
5. DISMORR M, et al. Effect of Prosthesis-Patient Mismatch on Long-Term Clinical Outcomes After Bioprosthetic Aortic Valve Replacement. Journal of the American College of Cardiology, 2023; 81(10): 964–975.
6. ESPOSITO G, et al. Predictors of post-TAVI conduction abnormalities in patients with bicuspid aortic valves. Open Heart, 2022; 9(2): e001995.
7. HARADA M, et al. Changes in platelet function and coagulation after transcatheter aortic valve implantation evaluated with thromboelastography. Open Heart, 2022; 9(2): e002132.
8. HUCZEK Z, et al. Transcatheter aortic valveinvalve implantation for failed surgical bioprostheses: results from the Polish Transcatheter Aortic Valve-in-Valve Implantation (ViVTAVI) Registry. Pol. Arch. Med. Wew. (Online), 2022; 132(2).
9. JALAVA MP, et al. Transcatheter and surgical aortic valve replacement in patients with left ventricular dysfunction. Journal of Cardiothoracic Surgery, 2022; 17(1): 322.
10. KANG SL, et al. Is there a role for endovascular stent implantation in the management of postoperative right ventricular outflow tract obstruction in the era of transcatheter valve implantation? Catheter Cardiovasc Interv, 2022; 99(4): 1138–1148.
11. KORCZAK A, et al. Acute kidney injury as the most important predictor of poor prognosis after interventional treatment for aortic stenosis. Kardiol Pol, 2022; 80(10): 1032–1038.
12. KUCK KH, et al. Cost-Effectiveness of SAPIEN 3 Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in German Severe Aortic Stenosis Patients at Low Surgical Mortality Risk. Adv Ther, 2023; 40(3): 1031–1046.
13. LANGE T, et al. Functional and structural reverse myocardial remodeling following transcatheter aortic valve replacement: a prospective cardiovascular magnetic resonance study. Journal of Cardiovascular Magnetic Resonance: Official Journal of the Society for Cardiovascular Magnetic Resonance, 2022; 24(1): 45.
14. MAGRO PL e SOUSA-UVA M. In low-risk patients aged >70-75 with severe aortic stenosis, is transcatheter superior to surgical aortic valve replacement in terms of reported cardiovascular composite outcomes and survival? Interact Cardiovasc Thorac Surg, 2022; 34(1): 40–44.
15. MAILEY JA, et al. Reframing Optimal Implantation of the Sapien 3 Transcatheter Heart Valve. The Journal of Invasive Cardiology, 2022; 34(5): 380–389.
16. MAJMUNDAR M, et al. Early outcomes of transcatheter versus surgical aortic valve implantation in patients with bicuspid aortic valve stenosis. EuroIntervention, 2022; 8(1): 23–32.
17. MCINERNEY A, et al. Transcatheter versus surgical aortic valve replacement in patients with morbid obesity: a multicentre propensity score-matched analysis. EuroIntervention, 2022; 18(5): 417–427.
18. MEDRANDA GA, et al. Lifetime management of patients with symptomatic severe aortic stenosis: a computed tomography simulation study. EuroIntervention: Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2022; 18(5): 407–416.
19. MUNERETTO C, et al. Sutureless versus transcatheter aortic valves in elderly patients with aortic stenosis at intermediate risk: A multi-institutional study. J Thorac Cardiovasc Surg, 2022; 163(3): 925- 935.
20. NARDI G, et al. Peripheral intravascular lithotripsy for transcatheter aortic valve implantation: a multicentre observational study. EuroIntervention: Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2022; 17(17): 1397–1406.
21. OKUNO T, et al. Transcatheter aortic valve implantation in patients with rheumatic aortic stenosis. Heart, 2022; 108(15): 1225–1233.
22. OLIEMY A e AL-ATTAR N. Transcatheter aortic valve implantation. F1000Prime Reports, 2014; 6: 92.
23. PEREIRA AS, et al. Metodologia da pesquisa científica. [s.l.] Brasil, 2018.
24. RAM E, et al. Frailty and clinical outcomes following aortic valve replacement. Journal of Cardiac Surgery, 2022; 37(10): 3036–3043.
25. RIZIK DG, et al. Long-term Outcomes of Transcatheter Aortic Valve Replacement With the Lotus Valve vs CoreValve/EvolutR: A Secondary Analysis of the REPRISE III Randomized Clinical Trial. JAMA network open, 2022; 5(10): e2238792.
26. ROBERTSON DM, et al. Transcatheter and Surgical Aortic Valve Implantation in Children, Adolescents, and Young Adults With Congenital Heart Disease. Am J Cardiol, 2022; 177: 128–136.
27. SÁ MP, et al. Late Outcomes After Aortic Root Enlargement During Aortic Valve Replacement: Meta-Analysis With Reconstructed Time-To-Event Data. J Cardiothorac Vasc Anesth, 2022; 36(8): 3065–3073.
28. SIQUEIRA DAA, et al. Single-center experience with merils myval transcatheter heart valve. J. Transcatheter Interv, 2022; 30(1): 100–101.
29. TARASOUTCHI F, et al. Atualização das Diretrizes Brasileiras de Valvopatias – 2020. Arquivos Brasileiros de Cardiologia, 2020; 115(4): 720–775.
30. THADEN JJ, et al. Sex-related differences in calcific aortic stenosis: correlating clinical and echocardiographic characteristics and computed tomography aortic valve calcium score to excised aortic valve weight. European Heart Journal, 2016; 37(8): 693–699.
31. TOMALA O, et al. Comparison of outcomes of trans-subclavian versus trans-apical approaches in transcatheter aortic valve implantation. Journal of Cardiothoracic Surgery, 2022; 17(1): 180.
32. TOMII D, et al. Long-term outcomes of new-onset conduction abnormalities following transcatheter aortic valve implantation. Archives of Cardiovascular Diseases, 2022; 115(4): 214–224.
33. TOMII D, et al. Impact of First-Phase Ejection Fraction on Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation. Cardiovascular Revascularization Medicine: Including Molecular Interventions, 2022; 42: 55–61.
34. INVESTIGATORS UTT, et al. Effect of Transcatheter Aortic Valve Implantation vs Surgical Aortic Valve Replacement on All-Cause Mortality in Patients With Aortic Stenosis: A Randomized Clinical Trial. JAMA, 2022; 327(19): 1875–1887.
35. WILLIAMS MR, et al. The PARTNER 3 Bicuspid Registry for Transcatheter Aortic Valve Replacement in Low-Surgical-Risk Patients. JACC Cardiovasc Interv, 2022; 15(5): 523–532.
2. ALASNAG M, et al. One-Year Outcomes for Patients Undergoing Transcatheter Aortic Valve Replacement: The Gulf TAVR Registry. Cardiovasc Revasc Med, 2022; 41: 19–26.
3. BAUMGARTNER H, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. European Heart Journal, 2017; 38(36): 2739–2791.
4. CHEN CG, et al. Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Low-risk Patients: A Meta-Analysis Based on a 2-Year Follow-Up. Anatol J Cardiol, 2022; 26(11): 802–809.
5. DISMORR M, et al. Effect of Prosthesis-Patient Mismatch on Long-Term Clinical Outcomes After Bioprosthetic Aortic Valve Replacement. Journal of the American College of Cardiology, 2023; 81(10): 964–975.
6. ESPOSITO G, et al. Predictors of post-TAVI conduction abnormalities in patients with bicuspid aortic valves. Open Heart, 2022; 9(2): e001995.
7. HARADA M, et al. Changes in platelet function and coagulation after transcatheter aortic valve implantation evaluated with thromboelastography. Open Heart, 2022; 9(2): e002132.
8. HUCZEK Z, et al. Transcatheter aortic valveinvalve implantation for failed surgical bioprostheses: results from the Polish Transcatheter Aortic Valve-in-Valve Implantation (ViVTAVI) Registry. Pol. Arch. Med. Wew. (Online), 2022; 132(2).
9. JALAVA MP, et al. Transcatheter and surgical aortic valve replacement in patients with left ventricular dysfunction. Journal of Cardiothoracic Surgery, 2022; 17(1): 322.
10. KANG SL, et al. Is there a role for endovascular stent implantation in the management of postoperative right ventricular outflow tract obstruction in the era of transcatheter valve implantation? Catheter Cardiovasc Interv, 2022; 99(4): 1138–1148.
11. KORCZAK A, et al. Acute kidney injury as the most important predictor of poor prognosis after interventional treatment for aortic stenosis. Kardiol Pol, 2022; 80(10): 1032–1038.
12. KUCK KH, et al. Cost-Effectiveness of SAPIEN 3 Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in German Severe Aortic Stenosis Patients at Low Surgical Mortality Risk. Adv Ther, 2023; 40(3): 1031–1046.
13. LANGE T, et al. Functional and structural reverse myocardial remodeling following transcatheter aortic valve replacement: a prospective cardiovascular magnetic resonance study. Journal of Cardiovascular Magnetic Resonance: Official Journal of the Society for Cardiovascular Magnetic Resonance, 2022; 24(1): 45.
14. MAGRO PL e SOUSA-UVA M. In low-risk patients aged >70-75 with severe aortic stenosis, is transcatheter superior to surgical aortic valve replacement in terms of reported cardiovascular composite outcomes and survival? Interact Cardiovasc Thorac Surg, 2022; 34(1): 40–44.
15. MAILEY JA, et al. Reframing Optimal Implantation of the Sapien 3 Transcatheter Heart Valve. The Journal of Invasive Cardiology, 2022; 34(5): 380–389.
16. MAJMUNDAR M, et al. Early outcomes of transcatheter versus surgical aortic valve implantation in patients with bicuspid aortic valve stenosis. EuroIntervention, 2022; 8(1): 23–32.
17. MCINERNEY A, et al. Transcatheter versus surgical aortic valve replacement in patients with morbid obesity: a multicentre propensity score-matched analysis. EuroIntervention, 2022; 18(5): 417–427.
18. MEDRANDA GA, et al. Lifetime management of patients with symptomatic severe aortic stenosis: a computed tomography simulation study. EuroIntervention: Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2022; 18(5): 407–416.
19. MUNERETTO C, et al. Sutureless versus transcatheter aortic valves in elderly patients with aortic stenosis at intermediate risk: A multi-institutional study. J Thorac Cardiovasc Surg, 2022; 163(3): 925- 935.
20. NARDI G, et al. Peripheral intravascular lithotripsy for transcatheter aortic valve implantation: a multicentre observational study. EuroIntervention: Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2022; 17(17): 1397–1406.
21. OKUNO T, et al. Transcatheter aortic valve implantation in patients with rheumatic aortic stenosis. Heart, 2022; 108(15): 1225–1233.
22. OLIEMY A e AL-ATTAR N. Transcatheter aortic valve implantation. F1000Prime Reports, 2014; 6: 92.
23. PEREIRA AS, et al. Metodologia da pesquisa científica. [s.l.] Brasil, 2018.
24. RAM E, et al. Frailty and clinical outcomes following aortic valve replacement. Journal of Cardiac Surgery, 2022; 37(10): 3036–3043.
25. RIZIK DG, et al. Long-term Outcomes of Transcatheter Aortic Valve Replacement With the Lotus Valve vs CoreValve/EvolutR: A Secondary Analysis of the REPRISE III Randomized Clinical Trial. JAMA network open, 2022; 5(10): e2238792.
26. ROBERTSON DM, et al. Transcatheter and Surgical Aortic Valve Implantation in Children, Adolescents, and Young Adults With Congenital Heart Disease. Am J Cardiol, 2022; 177: 128–136.
27. SÁ MP, et al. Late Outcomes After Aortic Root Enlargement During Aortic Valve Replacement: Meta-Analysis With Reconstructed Time-To-Event Data. J Cardiothorac Vasc Anesth, 2022; 36(8): 3065–3073.
28. SIQUEIRA DAA, et al. Single-center experience with merils myval transcatheter heart valve. J. Transcatheter Interv, 2022; 30(1): 100–101.
29. TARASOUTCHI F, et al. Atualização das Diretrizes Brasileiras de Valvopatias – 2020. Arquivos Brasileiros de Cardiologia, 2020; 115(4): 720–775.
30. THADEN JJ, et al. Sex-related differences in calcific aortic stenosis: correlating clinical and echocardiographic characteristics and computed tomography aortic valve calcium score to excised aortic valve weight. European Heart Journal, 2016; 37(8): 693–699.
31. TOMALA O, et al. Comparison of outcomes of trans-subclavian versus trans-apical approaches in transcatheter aortic valve implantation. Journal of Cardiothoracic Surgery, 2022; 17(1): 180.
32. TOMII D, et al. Long-term outcomes of new-onset conduction abnormalities following transcatheter aortic valve implantation. Archives of Cardiovascular Diseases, 2022; 115(4): 214–224.
33. TOMII D, et al. Impact of First-Phase Ejection Fraction on Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation. Cardiovascular Revascularization Medicine: Including Molecular Interventions, 2022; 42: 55–61.
34. INVESTIGATORS UTT, et al. Effect of Transcatheter Aortic Valve Implantation vs Surgical Aortic Valve Replacement on All-Cause Mortality in Patients With Aortic Stenosis: A Randomized Clinical Trial. JAMA, 2022; 327(19): 1875–1887.
35. WILLIAMS MR, et al. The PARTNER 3 Bicuspid Registry for Transcatheter Aortic Valve Replacement in Low-Surgical-Risk Patients. JACC Cardiovasc Interv, 2022; 15(5): 523–532.