RESUMEN
Transcatheter aortic valve implantation (TAVI) has become the standard treatment for advanced age and high risk patients with severe aortic stenosis. The incidence of life-threatening complications during TAVI has significantly decreased over the last decade due to advanced current surgical experience. However, there is a risk of perioperative life-threatening complications which can require emergency hemodynamic support. Veno-arterial extracorporeal membrane oxygenation (ECMO) may represent an effective strategy for immediate hemodynamic stabilization until further treatment of the underlying complication. It is presented case report of TAVI under ECMO performed at the Kemerovo Research Institute for Complex Issues of Cardiovascular Diseases. Emergency ECMO represents a feasible strategy for stabilization until further treatment of life-threatening complications during TAVI.
Asunto(s)
Estenosis de la Válvula Aórtica/cirugía , Válvula Aórtica/cirugía , Oxigenación por Membrana Extracorpórea , Reemplazo de la Válvula Aórtica Transcatéter/métodos , Estudios de Factibilidad , Prótesis Valvulares Cardíacas , Humanos , Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos , Resultado del TratamientoRESUMEN
THE AIM: Evaluates long-term clinical outcomes of percutaneous coronary intervention (PCI) with bioresorbable vascular scaffold (BVS) versus minimally invasive direct coronary artery bypass (MIDCAB) surgery for the treatment of left anterior descending (LAD) lesions. METHODS AND RESULTS: In this single-center study were included 130 patients with stable angina and significant (≥ 70 %) LAD disease. Patients were randomly assigned in a 1:1 ratio to PCI with everolimus-eluting BVS (n=65) or MIDCAB (n=65). The primary end-point was major adverse cerebro-cardiovascular events (MACCE) and secondary was scaffold (graft) thrombosis at 1 year. The groups of patients were comparable for all baseline demographic, clinical and angiographic parameters. MACCE at 12 month occurred in 9.2 % of patients in the BVS group and in 4.6 % of patients in the MIDCAB group (p=0.3). There was no significant difference between the groups in rates of all cause death (1.5 % vs 1.5 %, p=1.0), myocardial infarction (3.1 % vs. 6.1 %, p=0.4), any revascularization (1.5 % vs. 6.1 %, p=0.1) and scaffold (graft) thrombosis (1.5 % vs. 1.5 %, p=1.00). CONCLUSION: At 12-month follow up, there was no significant difference in the rate of MACCE between PCI by BVS and MIDCAB in patients with isolated LAD lesions.
Asunto(s)
Enfermedad de la Arteria Coronaria , Intervención Coronaria Percutánea , Implantes Absorbibles , Puente de Arteria Coronaria , Stents Liberadores de Fármacos , Estudios de Seguimiento , Humanos , Procedimientos Quirúrgicos Mínimamente Invasivos , Resultado del TratamientoRESUMEN
The article contains a review of the literature devoted to the state-of-the-art data concerning management of patients presenting with an aneurysmal lesion of the extracranial segment of the internal carotid artery. This is followed by describing two clinical case reports regarding aneurysms of the extracranial segment of the internal carotid artery and the outcomes of endovascular treatment.