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Aceleración anormal del flujo intracavitario ventricular izquierdo en pacientes sometidos a reemplazo de válvula
G Aurigemma1, S Battista, D Orsinelli
1Noninvasive Laboratory, University of Massachusetts Medical Center, Worcester 01655.
Circulation
|September 1, 1992
Resumen
La aceleración anormal del flujo intracavitario después del reemplazo de la válvula aórtica por estenosis aórtica indica mayores riesgos. Este hallazgo, identificado por ecocardiografía Doppler, está relacionado con el aumento de la mortalidad y morbilidad de los pacientes.
Área de la Ciencia:
- Cardiología Cardiología.
- La ecocardiografía es una ecocardiografía.
- Cirugía cardíaca Cirugía cardíaca.
Sus antecedentes:
- La estenosis aórtica es una enfermedad valvular cardíaca común.
- El reemplazo de la válvula aórtica (AVR) es un tratamiento estándar para la estenosis aórtica grave.
- La evaluación postoperatoria de los resultados de la RAV es crucial.
Objetivo del estudio:
- Para investigar las características clínicas y ecocardiográficas de los pacientes con aceleración del flujo intracavitario anormal después de AVR.
- Para determinar la asociación de este hallazgo con los resultados postoperatorios.
Principales métodos:
- Revisión retrospectiva de 53 pacientes sometidos a AVR por estenosis aórtica.
- La ecocardiografía Doppler postoperatoria para evaluar el flujo intracavitario.
- Comparación de pacientes con y sin aceleración anormal del flujo.
Principales resultados:
- Trece pacientes (grupo 1) mostraron una aceleración anormal del flujo intracavitario (gradiente medio de 104,6 mmHg).
- El grupo 1 tenía una geometría ventricular distinta (hipertrofia, cavidades más pequeñas, mayor fracción de eyección).
- El grupo 1 experimentó una mayor mortalidad posoperatoria (38% vs. 12%) y morbilidad.
Conclusiones:
- La aceleración anormal del flujo intracavitario post-AVR está asociada con una geometría ventricular específica y una función supernormal.
- Este hallazgo sirve como un marcador para el aumento de la morbilidad y mortalidad postoperatorias.
- La ecocardiografía Doppler ayuda en la estratificación del riesgo y la orientación terapéutica.
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