رسالة جامعية
Σύγκριση της διαδερμικής διά της υποκλειδίου αρτηρίας σε σχέση με τη διαμηριαία προσπέλαση τοποθέτηση αορτικής βαλβίδας σε ασθενείς με στένωση αορτικής βαλβίδος ; Transcatheter aortic valve implantation:assess the safety and efficacy of the trans-subclavian approach for TAVI, as compared with the transfemoral approach
| العنوان: | Σύγκριση της διαδερμικής διά της υποκλειδίου αρτηρίας σε σχέση με τη διαμηριαία προσπέλαση τοποθέτηση αορτικής βαλβίδας σε ασθενείς με στένωση αορτικής βαλβίδος ; Transcatheter aortic valve implantation:assess the safety and efficacy of the trans-subclavian approach for TAVI, as compared with the transfemoral approach |
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| المؤلفون: | Thomopoulou, Sofia, Θωμοπούλου, Σοφία |
| بيانات النشر: | National and Kapodistrian University of Athens Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ) |
| سنة النشر: | 2017 |
| المجموعة: | National Archive of PhD Theses (National Documentation Centre Greece) |
| مصطلحات موضوعية: | Υποκλείδιος αγγειακή προσπέλαση, Διακαθετηριακή αντικατάσταση αορτικής βαλβίδας, Στένωση αορτικής βαλβίδας, Transcatheter aortic valve implantation (TAVI), Trans-subclavian approach for TAVI, Aortic stenosis, Ιατρική και Επιστήμες Υγείας, Κλινική Ιατρική, Επιστήμες Υγείας, Ιατρική Βιοτεχνολογία, Medical and Health Sciences, Clinical Medicine, Health Sciences, Medical Biotechnology |
| الوصف: | Introduction: Transcatheter aortic valve implantation (TAVI) represents a challengingtherapeutic alternative for patients with severe aortic stenosis at high surgical risk. Arelevant number of TAVI candidates cannot undergo the standard transfemoral vascularaccess due to unfavourable iliofemoral anatomy or extensive atherosclerotic disease. Inthese patients, a trans-subclavian approach may be feasible.Aim: Our aim was to prospectively assess the safety and efficacy of the trans-subclavianapproach for TAVI, as compared with the transfemoral approach.Methods and results: We included 193 patients, who all underwent a percutaneous aorticvalve implantation between June 2008 and February 2015. The subclavian approach wasused in 36 cases (18.7%). The logistic Euro Score was significantly higher in the subclavianvs. femoral group (30.88 ± 10.8 vs. 25.78 ± 10.1; p = 0.009), as well as lower body massindex (24.29 ± 3.4 % vs. 26.91 ± 3.9%; p = 0.001), rate of peripheral artery disease (94.4vs. 32.7%, P <0.001) and rate of patients with low flow - low gradient severe aortic stenosis(34.3 vs.14.0%; p = 0.004). Procedural success was equally obtained in 97.2 vs. 94.9% ofthe subclavian vs. femoral groups, respectively (p = 0.876), with higher use of generalanaesthesia (94.4 to 41.4%; p < 0.001) and intraprocedural mortality of 2.8% vs. 0.6% (p =0.339). Need for permanent pacemaker implantation (41.4 vs. 36.9%; p = 0.654), acutekidney disease stage I–II (36.10% to 34.40%; p < 0.846) and major bleeding complications(36.10 to 34.60%; p = 0.865) were the most common in-hospital complications. But theincidence was not different between the two groups. However, acute myocardial injury (46.4to 23.5%; p = 0.014) and vascular complications (8.3 to 27.4%; p=0.016) were observedmore frequently in the subclavian approach. No specific serious complications related tosubclavian access (vessel rupture, vertebral or internal mammary ischaemia, brachialplexus injury) were reported. The prevalence of more than mild paravalvular leak ... |
| نوع الوثيقة: | doctoral or postdoctoral thesis |
| اللغة: | Greek, Modern (1453-) |
| العلاقة: | http://hdl.handle.net/10442/hedi/40346Test |
| DOI: | 10.12681/eadd/40346 |
| الإتاحة: | https://doi.org/10.12681/eadd/40346Test http://hdl.handle.net/10442/hedi/40346Test |
| رقم الانضمام: | edsbas.21FC2EE |
| قاعدة البيانات: | BASE |
| DOI: | 10.12681/eadd/40346 |
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