Outcomes of treatment of patients with severe symptomatic aortic stenosis treated with transcutaneous aortic valve implantation (TAVI) in Clinical Hospital Center Rijeka

Autor: Knezić, Filip
Přispěvatelé: Tomulić, Vjekoslav, Jakljević, Tomislav, Medved, Igor, Gobić, David
Jazyk: chorvatština
Rok vydání: 2021
Předmět:
Popis: Uvod: Aortalna stenoza je bolest koja nastaje radi suženja lumena aortalnog zalistka. Kad počne izazivati simptome, jedina definitivna terapijska metoda jest zamjena aortalnog zalistka. Ona može biti kirurška ili perkutana, TAVI zahvatom kojim se transkateterski ugradi novi, umjetni aortalni zalistak. Svrha: Svrha ovog istraživanja bila je usporediti uspješnost provođenja TAVI zahvata u Rijeci sa dostupnim rezultatima međunarodnih TAVI registara, te proučiti kako su se mijenjali rezultati nakon pet godina provođenja zahvata. Ispitanici i postupci: Ovaj istraživački rad koristio je podatke od ukupno 171 ispitanika kojima je u KBC-u Rijeka izveden TAVI zahvat. Iz IBIS-a su prikupljani opći podaci o ispitanicima, podaci o hospitalizaciji i TAVI zahvatu, te podaci o kontrolama i ishodu nakon otpusta iz bolnice. Prvo su analizirani ukupni podaci, a zatim su ispitanici podijeljeni u dvije skupine: prva uključuje TAVI zahvate od 01.01.2015. do 31.12.2019. godine, a druga od 01.01.2020. do 01.02.2021. godine. Rezultati i rasprava: Prosječni ispitanik je star 79,2 godine, preuhranjen, boluje od hipertenzije i hiperlipidemije, NYHA–III razreda. Smrtnost tijekom hospitalizacije iznosila je 6,5%, a najčešće komplikacije bile su AV-blok (10,5%), zatim krvarenje ubodnog mjesta (9,7%) i kontrastna nefropatija (5,3%). Nakon TAVI zahvata se NYHA razred u većini slučajeva značajno snizio, a došlo je i do značajnog poboljšanja ehokardiografskih nalaza (EF, vMax i ΔPmax). NYHA razred, preživljenje i broj komplikacija statistički su značajno niži u drugoj skupini bolesnika u odnosu na prvu. Zaključak: Ukupni rezultati zahvata učinjenih u KBC-u Rijeka usporedivi su sa rezultatima međunarodnih TAVI registara. Između rezultata prve i druge skupine ispitanika postoji značajno poboljšanje.
Introduction: Aortic stenosis is a disease caused by the narrowing of the aortic valve. The only definitive therapeutic method once it starts causing symptoms is aortic valve replacement, which can be done surgically or by TAVI, a percutaneous procedure used to implant a new, artificial aortic valve. Purpose: The purpose of this study was to compare the success of TAVI interventions in Rijeka with the results of international TAVI registers, and to see how the results changed after five years of implementation. Materials and methods: This study used data from a total of 171 patients who underwent TAVI procedure at the University Hospital Center in Rijeka. General patient data, hospitalization and TAVI data, as well as follow-up data were collected from the hospital information system. First, the total data was analyzed, and then the patients were divided into two groups: the first included TAVI procedures done between January 1st 2015 and December 31st 2019, and the second between January 1st 2020 and February 1st 2021. Results and discussion: The average patient was 79,2 years old, overweight, had hypertension and hyperlipidemia, and is NYHA class III. Mortality during hospitalization was 6,5%, and the most common complications were AV-block (10,5%), followed by bleeding (9,7%), and contrast nephropathy (5,3%). At the follow-up, the NYHA class decreased significantly in most cases, and there was a significant improvement in echocardiographic findings (EF, vMax, and ΔPmax). NYHA class, mortality and complications rate were statistically lower in the second group compared to the first group of patients. Conclusion: The overall results achieved in University Hospital Center in Rijeka are comparable to the results of international TAVI registers. There was significant improvement between the results of the first and second group of patients.
Databáze: OpenAIRE
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