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Resultados en adultos con válvulas aórticas bicúspidas
Nikolaos Tzemos1, Judith Therrien, James Yip
1Peter Munk Cardiac Centre and Toronto Congenital Cardiac Centre for Adults, University Health Network, University of Toronto, Toronto, Ontario, Canada.
JAMA
|September 19, 2008
Resumen
Los adultos con válvula aórtica bicúspide enfrentan eventos cardíacos, siendo la edad y la condición de la válvula los predictores clave. Sin embargo, las tasas de supervivencia siguen siendo comparables a la población general durante un seguimiento de 9 años.
Área de la Ciencia:
- Cardiología Cardiología.
- Enfermedad cardíaca congénita.
- Enfermedad de la válvula aórtica enfermedad de la válvula aórtica
Sus antecedentes:
- La válvula aórtica bicúspide (VAB) es la anomalía cardíaca congénita más frecuente en los adultos.
- Los resultados cardíacos contemporáneos en pacientes con BAV requieren una evaluación sistemática.
Objetivo del estudio:
- Determinar la frecuencia y los predictores de los resultados cardíacos en una gran cohorte de adultos con BAV.
- Para evaluar las tasas de eventos cardíacos a largo plazo y la supervivencia en una población BAV contemporánea.
Principales métodos:
- Un estudio de cohorte siguió a 642 adultos ambulatorios consecutivos con VAB durante una media de 9 años.
- El análisis multivariado identificó predictores de eventos cardíacos importantes, incluida la muerte cardíaca, las intervenciones aórticas, la disección, el aneurisma y la insuficiencia cardíaca.
- Las tasas de mortalidad se compararon con las estimaciones de la población general ajustadas por edad y sexo.
Principales resultados:
- Los eventos cardíacos primarios ocurrieron en el 25% de los pacientes, siendo las intervenciones de la válvula aórtica / aorta ascendente las más comunes (22%).
- Los predictores independientes para eventos cardíacos incluyeron edad >30 años, estenosis aórtica moderada/severa y regurgitación aórtica moderada/severa.
- La tasa de supervivencia a 10 años fue del 96%, no significativamente diferente de la población general.
Conclusiones:
- La edad, la gravedad de la estenosis aórtica y la gravedad de la regurgitación aórtica son predictores independientes de eventos cardíacos en adultos con BAV.
- A pesar de los posibles eventos cardíacos, la supervivencia a largo plazo de los adultos jóvenes con BAV es comparable a la de la población general.
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