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Estenosis aórtica y pequeño anillo aórtico
Afonso B Freitas-Ferraz1, Gabriela Tirado-Conte1, Francois Dagenais1
1Quebec Heart and Lung Institute, Laval University, Quebec City, Canada (A.B.F.-F., G.T.-C., F.D., E.D., S.M., M.B., P.P., J.R.-C.).
Circulation
|June 4, 2019
Resumen
El manejo de la estenosis aórtica grave con un anillo aórtico pequeño es un desafío, especialmente para las mujeres mayores. Esta revisión evalúa las estrategias terapéuticas para mejorar la hemodinámica y los resultados para este grupo de pacientes.
Área de la Ciencia:
- Cardiología
- Cirugía cardíaca
- Cardiología intervencionista
Sus antecedentes:
- El pequeño anillo aórtico es un desafío frecuente en la estenosis aórtica grave, especialmente en mujeres mayores.
- Las estrategias de manejo óptimas para los pacientes con anillo aórtico pequeño siguen siendo controvertidas.
- Las opciones quirúrgicas existentes incluyen la ampliación de la raíz aórtica y varias válvulas protésicas.
Objetivo del estudio:
- Definir y revisar la prevalencia y el impacto clínico del anillo aórtico pequeño en la estenosis aórtica.
- Evaluar las estrategias terapéuticas actuales para mejorar la hemodinámica y los resultados en esta población.
- Para resaltar el reemplazo de la válvula aórtica transcatéter como una alternativa viable.
Principales métodos:
- Revisión de la literatura de las definiciones actuales, prevalencia e impacto clínico.
- Análisis de las estrategias quirúrgicas y terapéuticas transcatéter.
- Evaluación de los datos hemodinámicos y clínicos.
Principales resultados:
- El pequeño anillo aórtico presenta desafíos significativos en el manejo de la estenosis aórtica grave.
- Varias técnicas quirúrgicas tienen como objetivo mejorar la hemodinámica de la válvula y los resultados del paciente.
- El reemplazo de la válvula aórtica transcatéter muestra resultados hemodinámicos prometedores en esta cohorte.
Conclusiones:
- El tratamiento eficaz del pequeño anillo aórtico en la estenosis aórtica requiere una cuidadosa consideración de las opciones terapéuticas disponibles.
- El reemplazo de la válvula aórtica transcatéter ofrece una alternativa valiosa, especialmente para los pacientes ancianos.
- Se necesitan más investigaciones para optimizar las estrategias de tratamiento y los resultados a largo plazo.
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