Avaliação do implante valvar aórtico transcateter com a prótese Inovare Proseal® pela tomografia computadorizada de múltiplos detectores

• Ano de defesa: 2019
• Autor(a) principal: Flori, Apoana Gomes [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Aortic Valve; Cardiac Valve Implant; Computed Tomography; Transcatheter; Valva Aórtica; Implante De Prótese De Valva Cardíaca; Tomografia Computadorizada; Transcateter
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7688651; https://repositorio.unifesp.br/handle/11600/59356

OBJECTIVES: Transcatheter aortic valve replacement (TAVR) is an established procedure for high-risk patients. The Braile Inovare Proseal was developed to reduce the incidence of paravalvular leakage (PVL). Our aim was to evaluate device performance and additionally preand post-operative aortic annulus and the transcatheter prosthesis using multislice computed tomography (MSCT). METHODS: Patients were selected by a multidisciplinary heart team and referred for TAVR. MSCT was performed before and after surgery. Measurements of the aortic valve and prosthesis were conducted and correlated with the valve gradient and residual paravalvular leakage. RESULTS: 21 patients were selected for the protocol. Patients had a mean age of 79 years old and 38% were of female sex. Mean EuroSCORE II was 12.5% ± 10.8. Mean gradient was also reduced from 45.8 ± 11.04 mmHg to 5.59 ± 2.61 mmHg and there were no instances of PVL worse than mild. There were no cases of coronary obstruction or procedural death. Circularity was present in all prostheses evaluated. Circularity indexes for the prostheses were: inflow 0.05 ± 0,03, middle third 0.03 ± 0,02 and outflow 0.03 ± 0,02. The mean distance between the prosthesis and the left and right coronary ostia were 14,8 mm ± 3,3 and 17,3 mm ± 3, respectively. The degree of oversizing was appropriate with a mean of 22.14%. CONCLUSION: Braile Inovare ProSeal transcatheter device has demonstrated good clinical results with low rates of PVL. MSCT was an adequate technique to evaluate device sizing and has demonstrated preserved expansibility and circularity in the evaluated cases.