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Implantación de válvula aórtica percutánea retrógrada desde la arteria femoral
John G Webb1, Mann Chandavimol, Christopher R Thompson
1Division of Cardiology, St. Paul's Hospital, Vancouver, British Columbia, Canada. webb@providencehealth.bc.ca
Circulation
|February 8, 2006
Resumen
La implantación de la válvula aórtica transcatéter a través de la arteria femoral es un procedimiento factible para pacientes de alto riesgo. Este enfoque retrógrado demostró una implantación exitosa y mejoró el área de la válvula aórtica con una buena supervivencia a corto plazo.
Área de la Ciencia:
- Cirugía cardiovascular La cirugía cardiovascular es una cirugía cardiovascular.
- Cardiología Intervencionista Cardiología intervencionista.
- Ingeniería Biomédica Ingeniería Biomédica.
Sus antecedentes:
- La implantación de la válvula aórtica transvenosa antegrada es problemática.
- La implantación retrógrada de prótesis de válvula aórtica a través de la arteria femoral ofrece ventajas potenciales.
- Este estudio informa de la experiencia inicial con la implantación percutánea de prótesis de válvula aórtica a través del enfoque de la arteria femoral.
Objetivo del estudio:
- Para describir la técnica de implantación percutánea de la válvula aórtica transarterial.
- Informar sobre la experiencia clínica inicial y los resultados de este nuevo procedimiento.
- Evaluar la viabilidad y seguridad de este enfoque en pacientes de alto riesgo.
Principales métodos:
- Se utilizó una prótesis construida a partir de un stent de acero inoxidable con una válvula pericárdica equina.
- Se avanzó una vaina de 22F o 24F desde la arteria femoral hasta la aorta.
- La prótesis fue manipulada usando un catéter direccionable, y desplegada utilizando el ritmo ventricular rápido y la inflación del globo.
Principales resultados:
- Se intentó la implantación percutánea de prótesis de válvula aórtica en 18 pacientes de alto riesgo (edad media de 81 años).
- Se logró una implantación exitosa en 14 pacientes.
- El área de la válvula aórtica aumentó significativamente (0,6 a 1,6 cm2), con un 89% de supervivencia a los 75 días de seguimiento. La lesión de la arteria ilíaca se manejó de manera efectiva después de los casos iniciales.
Conclusiones:
- La implantación percutánea de la válvula aórtica transarterial es factible en pacientes seleccionados de alto riesgo.
- El procedimiento demostró resultados satisfactorios a corto plazo.
- Este enfoque representa una alternativa viable para los pacientes inadecuados para el reemplazo quirúrgico de válvulas.
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