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3.
PLoS One ; 15(7): e0236265, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32697799

RESUMO

AIMS: The preprocedural assessment of outcomes and patients' prognosis after interventional therapy of functional MR (FMR) is uncertain. Therefore, we aim to develop an easy-to-handle scoring system for adequate prediction of individual outcomes in patients with FMR after the interventional treatment. MATERIALS AND METHODS: We retrospectively used medical data of patients with symptomatic FMR, who underwent transcatheter mitral valve repair (TMVR) from January 2014 to August 2016 in our heart center. All patients had the mean follow-up of 18 months. All clinical and echocardiographic data originate from the "Bonner Mitral Valve Register Database". RESULTS: We included 105 patients (76,7±8,8 years, 50,6% female) with symptomatic (NYHA functional class>II) moderate-to-severe or severe FMR at surgical high-risk. We modified the MIDA-Score for degenerative MR (DMR) according to the varying underlying pathomechanisms of FMR, called as "The modified MIDA Score". We found all-cause mortality of 7% within 18 months after the procedure. 34,1% of our cohort was rehospitalized; 90% of those were due to cardiovascular causes. The modified MIDA score was found to be a strong predictor for mortality and rehospitalization in patients with FMR (AUC: 0,89) and superior to the other conventional scoring systems in prediction of mortality (The modified MIDA-Score: AUC: 0,8, EuroSCORE II: AUC: 0,57, STS-Score: AUC: 0,51). The logistic regression analysis showed the modified MIDA score > 9 points to be the strongest predictor for mortality and rehospitalization after TMVR (OR: 3,35, p = 0,011). CONCLUSION: The modified MIDA score was found to be a promising, easy-to-handle, elementary scoring system for adequate prediction of individual postinterventional prognosis in patients with FMR undergoing TMVR. Further evaluation and validation of this novel scoring system in prospective multicentric studies with a large number of patients is warranted.


Assuntos
Cateterismo Cardíaco , Procedimentos Cirúrgicos Cardíacos , Insuficiência da Valva Mitral/cirurgia , Índice de Gravidade de Doença , Idoso , Idoso de 80 Anos ou mais , Ecocardiografia , Feminino , Humanos , Masculino , Valva Mitral/diagnóstico por imagem , Valva Mitral/fisiopatologia , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/diagnóstico , Insuficiência da Valva Mitral/mortalidade , Readmissão do Paciente/estatística & dados numéricos , Período Pré-Operatório , Prognóstico , Recidiva , Estudos Retrospectivos , Resultado do Tratamento
4.
J Cardiovasc Magn Reson ; 22(1): 55, 2020 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-32727590

RESUMO

BACKGROUND: A comprehensive non-invasive evaluation of bioprosthetic mitral valve (BMV) function can be challenging. We describe a novel method to assess BMV effective orifice area (EOA) based on phase contrast (PC) cardiovascular magnetic resonance (CMR) data. We compare the performance of this new method to Doppler and in vitro reference standards. METHODS: Four sizes of normal BMVs (27, 29, 31, 33 mm) and 4 stenotic BMVs (27 mm and 29 mm, with mild or severe leaflet obstruction) were evaluated using a CMR- compatible flow loop. BMVs were evaluated with PC-CMR and Doppler methods under flow conditions of; 70 mL, 90 mL and 110 mL/beat (n = 24). PC-EOA was calculated as PC-CMR flow volume divided by the PC- time velocity integral (TVI). RESULTS: PC-CMR measurements of the diastolic peak velocity and TVI correlated strongly with Doppler values (r = 0.99, P < 0.001 and r = 0.99, P < 0.001, respectively). Across all conditions tested, the Doppler and PC-CMR measurement of EOA (1.4 ± 0.5 vs 1.5 ± 0.7 cm2, respectively) correlated highly (r = 0.99, P < 0.001), with a minimum bias of 0.13 cm2, and narrow limits of agreement (- 0.2 to 0.5 cm2). CONCLUSION: We describe a novel method to assess BMV function based on PC measures of transvalvular flow volume and velocity integration. PC-CMR methods can be used to accurately measure EOA for both normal and stenotic BMV's and may provide an important new parameter of BMV function when Doppler methods are unobtainable or unreliable.


Assuntos
Bioprótese , Ecocardiografia Doppler em Cores , Implante de Prótese de Valva Cardíaca/instrumentação , Próteses Valvulares Cardíacas , Hemodinâmica , Imagem por Ressonância Magnética , Estenose da Valva Mitral/diagnóstico por imagem , Valva Mitral/diagnóstico por imagem , Velocidade do Fluxo Sanguíneo , Estudos de Viabilidade , Implante de Prótese de Valva Cardíaca/efeitos adversos , Humanos , Valva Mitral/fisiopatologia , Valva Mitral/cirurgia , Estenose da Valva Mitral/fisiopatologia , Estenose da Valva Mitral/cirurgia , Variações Dependentes do Observador , Valor Preditivo dos Testes , Desenho de Prótese , Reprodutibilidade dos Testes
5.
J Card Surg ; 35(8): 1871-1876, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32652703

RESUMO

BACKGROUND AND AIM: Mitral valve (MV) surgeries create electrophysiological substrates that give rise to postoperative arrhythmias. MV surgical procedures have been associated with macro- and microreentrant arrhythmogenic circuits, as well as circuits involving the atrial roof. It is not well understood why such arrhythmias develop; therefore, the aim of this study was to describe clinical and procedure characteristics associated with atrial arrhythmias in patients with prior MV surgery. METHODS: This retrospective chart review evaluated patients who had prior MV surgery and ablation procedures for atrial tachycardia between 2014 and 2018 (n = 20). Patients were classified into those exhibiting typical atrial flutter or another atrial tachyarrhythmia. RESULTS: Within the 20 patient cases reviewed, 30 arrhythmias were documented. Two-thirds of arrhythmias were typical atrial flutter; the percent incidence of arrhythmias originating in the right atrial (RA) roof, around the right atriotomy scar, in the left atrium, and at the crista terminalis was 20%, 3%, 7%, and 7%, respectively. Nearly every case of RA roof flutter (n = 5/6) and most arrhythmias (n = 20/30) occurred in patients who had a transseptal approach during MV surgery. Voltage maps did not show clear differences in scarring between groups. CONCLUSION: Results from this study suggest that an arrhythmogenic substrate for RA roof tachycardias is generated by transseptal approaches for MV surgery. This substrate is not clearly related to a surgical scar. These data suggest that other approaches should be considered for MV surgeries. Additionally, more research is needed to determine the mechanism for this nonscar-related arrhythmia substrate.


Assuntos
Arritmias Cardíacas/epidemiologia , Valva Mitral/cirurgia , Complicações Pós-Operatórias/epidemiologia , Humanos , Prevalência , Estudos Retrospectivos
6.
J Cardiovasc Surg (Torino) ; 61(4): 496-504, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32715718

RESUMO

BACKGROUND: Rheumatic mitral valve repair and replacement techniques are frequently used with excellent outcomes in experienced centers. This study aims to evaluate the impact of procedural types on left ventricular function in quinquagenarians. METHODS: Between January 2018 and September 2019, patients with severe rheumatic mitral stenosis were prospectively recruited. Propensity score matching was performed to reduce the selection bias. We compared the strain, twist and synchrony parameters of left ventricle in 70 quinquagenarian patients who underwent rheumatic mitral valve repair and replacement 12 hours before surgery, at 7 days and 6 months postoperatively. RESULTS: The overall group displayed significant improvement of left ventricular deformation after rheumatic mitral valve surgery. Compared with patients undergoing posterior chordal-sparing mitral valve replacement, patients undergoing rheumatic mitral valve repair showed more significant amelioration in global longitudinal strain (-18.6% versus -16.2%, P<0.001), twist (18.2° versus 15.9°, P<0.001), torsion (1.8°/cm versus 1.3°/cm, P<0.001), apical rotation (10.5° versus 8.8°, P<0.001), basal rotation (-7.7° versus -7.1°, P=0.049), systolic dyssynchrony index (4.7% versus 5.1%, P=0.021), standard deviation of time to peak longitudinal (46.9 ms versus 49.3 ms, P=0.024) and radial strain (15.8 ms versus 17.1 ms, P=0.037) at 6-month follow-up. CONCLUSIONS: Rheumatic mitral valve repair might provide patients with better postoperative left ventricular performance than posterior chordal-sparing mitral valve replacement. Longer follow-up is required to compare long-term outcomes.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Insuficiência da Valva Mitral/cirurgia , Cardiopatia Reumática/cirurgia , Função Ventricular Esquerda , Ecocardiografia Tridimensional , Feminino , Próteses Valvulares Cardíacas , Implante de Prótese de Valva Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/diagnóstico por imagem , Pontuação de Propensão , Estudos Prospectivos , Reprodutibilidade dos Testes , Cardiopatia Reumática/diagnóstico por imagem
7.
Kyobu Geka ; 73(7): 490-495, 2020 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-32641667

RESUMO

Minimally invasive cardiac surgery (MICS) via mini-right thoracotomy approach has been developed and standardized in the last 30 years, aiming to facilitate postoperative recovery and to minimize surgery-related complications. Mitral regurgitation is the major target of this MICS approach. In our institute, MICS mitral valve repair by direct vision under thoracoscopy guidance has been performed in 139 cases between 2011 and March 2018. Subsequently, robot-assisted surgery program was launched to perform mitral valve repair for 130 patients in the last 2 years. In-hospital and mid-term outcome post-mitral valve repair was not significantly different among sternotomy, MICS direct vision and MICS robot-assist approaches, though there were several pitfalls through the launch of the MICS program. Standardization of the MICS approach of mitral valve repair and other cardiac surgeries was herein summarized and associated pitfalls were explained from surgeons' view.


Assuntos
Implante de Prótese de Valva Cardíaca , Insuficiência da Valva Mitral/cirurgia , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos , Valva Mitral/cirurgia , Esternotomia , Toracotomia , Resultado do Tratamento
8.
Asian Cardiovasc Thorac Ann ; 28(5): 276-278, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32479110

RESUMO

An 86-year-old female with severe aortic valve stenosis underwent transcatheter aortic valve replacement. A balloon-expandable valve was used, guided by a double-stiff guidewire that successfully straightened the aorta. During valve placement, the balloon shifted. After placement of the prosthetic valve, intraoperative transesophageal echocardiography revealed severe mitral regurgitation from the anterior mitral leaflet. Open conversion was performed immediately. A 5-mm hole was identified in the anterior leaflet, and direct closure was chosen for mitral valve repair. While transcatheter aortic valve replacement has gained popularity for patients with severe aortic stenosis and high operative risk, reports of mitral valve perforation are rare.


Assuntos
Estenose da Valva Aórtica/cirurgia , Valvuloplastia com Balão/efeitos adversos , Traumatismos Cardíacos/etiologia , Insuficiência da Valva Mitral/etiologia , Valva Mitral/lesões , Substituição da Valva Aórtica Transcateter/efeitos adversos , Idoso de 80 Anos ou mais , Estenose da Valva Aórtica/diagnóstico por imagem , Feminino , Traumatismos Cardíacos/diagnóstico por imagem , Traumatismos Cardíacos/cirurgia , Humanos , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/cirurgia , Índice de Gravidade de Doença , Resultado do Tratamento
9.
Rev. cir. (Impr.) ; 72(3): 231-235, jun. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1115547

RESUMO

Resumen Introducción: La disección de la aurícula izquierda es una complicación infrecuente, pero potencialmente fatal de la cirugía cardíaca. Es frecuentemente asociada a cirugías de la válvula mitral, tanto su reparación el reemplazo, con una incidencia de 0,16%. Sin embargo, otros procedimientos como intervenciones percutáneas también presentan este riesgo. Objetivos: Presentar la resolución quirúrgica de un caso de disección de aurícula izquierda y aportar a la casuística nacional. Materiales y Método: Registro clínico, imagenológico y fotográfico del episodio clínico. Resultados: Una paciente que fue sometida a ablación por radiofrecuencia por vía retrógrada, y cursa durante el periodo postintervencional con insuficiencia cardíaca y su estudio identifica una disección auricular. Se realiza reparación del anillo mitral, plastía del aparato subvalvular y parche de pericardio, la paciente presenta evolución clínica y ecográfica favorable. Discusión: El tratamiento de esta entidad debe analizarse caso a caso, ya que la etiología relacionada a procedimientos percutáneos es diferente a la causada por cirugía valvular mitral. Conclusión: La reparación de una disección auricular con parche es una buena alternativa de tratamiento en estos casos.


Introduction: Left atrial dissection is an infrequent but potentially fatal complication of cardiac surgery. It is frequently associated with mitral valve surgery, both its repair and replacement, with an incidence of 0.16%. However, other procedures such as percutaneous interventions can also be predisposing factors. Objectives: To report the surgical resolution of a left atrial dissection case and contribute to the national casuistry. Materials and Method: Clinical, imaging and photographic record of the clinical episode. Results: A patient who underwent retrograde radiofrequency ablation during the post-interventional period with heart failure and whose study identifies an atrial dissection. Mitral ring repair, subvalvular apparatus repair and pericardial patch was performed, the patient evolves with favorable clinical and sonographic evolution. Discussion: The treatment of this entity should be analyzed case by case, the etiology related to percutaneous procedures is different to that caused by mitral valve surgery and this should be considered when choosing a therapeutic option. Conclusion: Repairing an atrial dissection with a patch is a good alternative in these cases.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Aneurisma Dissecante/cirurgia , Aneurisma Dissecante/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Doenças Raras , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Valva Mitral/cirurgia
10.
Expert Rev Med Devices ; 17(7): 627-636, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32567388

RESUMO

INTRODUCTION: In patients with severe mitral regurgitation (MR), transcatheter mitral valve replacement (TMVR) has recently emerged as an alternative to surgery. However, compared with transcatheter aortic valve replacement, TMVR faces several technical challenges and a high screening failure rate, mainly due to a more complex mitral annulus geometry and the potential interaction with the sub-valvular apparatus and the left ventricular outflow tract (LVOT). The AltaValve system is a device intended for TMVR with unique design features that may overcome most anatomical limitations for this therapy. AREAS COVERED: A summary of the current evidence regarding TMVR is presented, followed by a review of the main technical challenges. The main features, differential characteristics, and potential advantages of the AltaValve system are discussed. Finally, we describe the first-in-human procedures with AltaValve and the main details of the upcoming feasibility trial. EXPERT OPINION: A high number of high-risk surgical patients with MR remain undertreated. TMVR is continuously evolving, and AltaValve constitutes another step forward in this field. Its unique design avoiding annular and LVOT engagement represents a clear potential benefit, along with its recently incorporated trans-septal approach system. However, more evidence is warranted regarding its feasibility in different clinical settings and mid-term performance.


Assuntos
Implante de Prótese de Valva Cardíaca/efeitos adversos , Implante de Prótese de Valva Cardíaca/instrumentação , Valva Mitral/cirurgia , Animais , Calcinose/cirurgia , Estudos de Viabilidade , Humanos , Valva Mitral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Resultado do Tratamento
11.
Ann Thorac Cardiovasc Surg ; 26(4): 196-201, 2020 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-32493872

RESUMO

OBJECTIVE: To evaluate the effect of music therapy on the chronic pain and midterm quality of life of patients after mechanical valve replacement. METHODS: Patients were divided into two groups according to whether or not they received music therapy. The patients in the music group received 30 minutes of music therapy every day for 6 months after the operation. The patients in the control group received standard treatment and had 30 minutes of quiet rest time every day in the same period. The short-form of McGill Pain Questionnaire (SF-MPQ) was used to evaluate the degree of postoperative chronic pain, and the SF-36 was used to evaluate the midterm quality of life of patients. RESULTS: In terms of the degree of postoperative chronic pain, the score of the pain rating index (PRI) emotional item in the music group was significantly lower than that in the control group. In the evaluation of the postoperative midterm quality of life using the SF-36, the emotional function score in the music group was significantly higher than that in the control group. CONCLUSION: This study preliminarily showed that music therapy can effectively reduce chronic pain and improve midterm quality of life after surgery.


Assuntos
Valva Aórtica/cirurgia , Dor Crônica/terapia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Valva Mitral/cirurgia , Musicoterapia , Dor Pós-Operatória/terapia , Qualidade de Vida , China , Dor Crônica/diagnóstico , Dor Crônica/fisiopatologia , Dor Crônica/psicologia , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Percepção da Dor , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/fisiopatologia , Dor Pós-Operatória/psicologia , Fatores de Tempo , Resultado do Tratamento
13.
J Card Surg ; 35(8): 1769-1777, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32598528

RESUMO

BACKGROUND: The aim of this study was to evaluate the results after stented porcine xenograft implantation (Epic, SJM, St Paul, MN) with Linx anticalcification treatment in elderly patients at our high-volume tertiary care center. METHODS: A total of 3825 patients undergoing aortic (AVR = 2441), mitral (MVR = 892), or double valve (DVR = 492) replacement between 11/2001 and 12/2017 with Epic xenografts were evaluated. Outcomes were assessed by reviewing the prospectively acquired hospital database results, and regular annual follow-up information was acquired from questionnaires or telephone interviews. RESULTS: For patients undergoing AVR, MVR, DVR, age at surgery were 76.4 ± 6, 71.2 ± 9, 72.9 ± 8 years; active endocarditis was an indication for valve surgery in 4.5%, 20.7%, 19.7%; and the predicted median (interquartile range [IQR]) mortality risk (EuroSCORE II) was 5.2% (3.1%-9.4%), 7.5% (3.9%-16.2%), 9.9% (6.0%-19.6%), respectively. Median follow-up was 3.04 (IQR: 0.18-5.21). Thirty-day survival was 91.2% ± 0.6%, 87.6% ± 0.1.1%, 84.7% ± 1.6%; and 10-year survival was 56.7% ± 1.0%, 59.4% ± 2.5%, 50.45% ± 3.1%, respectively. Patients who underwent MVR versus AVR were at significant increased risk for reoperation for endocarditis (adjusted odds ratio; 2.2, 95% confidence interval; 1.29-3.7; P = .003). There was no significant difference in all-cause mortality at midterm in AVR vs MVR in the matched cohort (P = .85). CONCLUSIONS: Implantation of the Epic stented porcine xenograft is associated with acceptable survival and freedom from valve-related complications or reoperation due to structural valve disease at midterm follow-up.


Assuntos
Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Xenoenxertos , Valva Mitral/cirurgia , Idoso , Animais , Feminino , Implante de Prótese de Valva Cardíaca/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Risco , Taxa de Sobrevida , Suínos , Fatores de Tempo , Resultado do Tratamento
14.
J Cardiothorac Surg ; 15(1): 72, 2020 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-32375843

RESUMO

OBJECTIVE: The purpose of this study was to evaluate the effect of continuous nursing interventions on valve noise-related anxiety in patients undergoing mechanical mitral valve replacement (MVR) and to analyze its impact on patient quality of life. METHODS: Ninety patients who underwent mechanical MVR were divided into two groups. All patients in group A received routine nursing care. In addition to this intervention, an assigned nurse periodically provided patients in group B with continuous nursing interventions and ongoing health consultations during a 1-year follow-up. A hospital anxiety and depression (HAD) scale, a customized questionnaire and a Short Form Health Status 36 (SF-36) score questionnaire were used as the research tools. RESULTS: The postoperative HAD scores were better in group B than in group A, but the differences in most of the data were not statistically significant between the groups, except for HA sections 0-7 and 11-21. Based on the customized questionnaire, the subjective disturbance level was significantly lower in group B than in group A (the results of Q1 and Q4 were statistically significant). With regard to the SF-36 scores, group B was superior to group A in general health, emotional function and mental health, while the other dimensions had no significant difference. CONCLUSIONS: Compared with routine care, patients who received continuous care intervention after mechanical MVR had fewer anxiety symptoms and better quality of life.


Assuntos
Ansiedade/enfermagem , Implante de Prótese de Valva Cardíaca/enfermagem , Próteses Valvulares Cardíacas/psicologia , Valva Mitral/cirurgia , Ruído , Papel do Profissional de Enfermagem , Qualidade de Vida/psicologia , Idoso , Ansiedade/psicologia , Feminino , Implante de Prótese de Valva Cardíaca/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Inquéritos e Questionários
15.
J Cardiothorac Surg ; 15(1): 74, 2020 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-32381038

RESUMO

BACKGROUND: Hypo-attenuated leaflet thickening (HALT) in bioprosthetic aortic valve has been studied, but its equivalent in bioprosthetic mitral valve (bMV) remains uncharacterized. We sought to identify the prevalence, hemodynamic characteristics, and significance of anticoagulation therapy in bMV HALT. METHODS: A single-center cross-sectional study of 53 consecutive patients who underwent mitral valve replacement (MVR) with bMV between 2007 and 2017 was conducted. Cardiac-gated contrasted CT scans were obtained. Anticoagulant and antiplatelet therapy use were ascertained at the time of hospital discharge and CT scanning. Patient characteristics, postoperative stroke, and hemodynamic profile by echocardiogram were obtained to descriptively characterize the prevalence and characteristics associated with bMV HALT. RESULTS: Three patients (5.7%) were found to have a HALT on bMV. The mean time from index MVR to CT scan was 3.4 ± 0.8 years in HALT cohort and 3.4 ± 2.7 years in non-HALT cohort. Fifty patients (94.3%) were discharged on warfarin, and 37 patients (69.8%) were on warfarin at the time of CT scans. One patient with HALT was on therapeutic warfarin at the time of the CT scan that identified HALT. All three patients were asymptomatic at the time of CT scan. In patients with HALT, mean transmitral pressure gradient were 8, 5, and 2.7 mmHg, all with trivial or mild mitral regurgitation. CONCLUSIONS: In this study, the prevalence of HALT was low at 5.7%, all presenting without symptoms. One patient presented with HALT while on therapeutic oral anticoagulation, which may suggest thrombotic etiology may not adequately explain HALT.


Assuntos
Bioprótese , Doenças das Valvas Cardíacas/epidemiologia , Próteses Valvulares Cardíacas , Valva Mitral/cirurgia , Complicações Pós-Operatórias/epidemiologia , Trombose/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Estudos Transversais , Ecocardiografia , Feminino , Doenças das Valvas Cardíacas/diagnóstico por imagem , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/epidemiologia , Inibidores da Agregação de Plaquetas/uso terapêutico , Complicações Pós-Operatórias/diagnóstico por imagem , Trombose/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Varfarina/uso terapêutico
20.
Radiol Clin North Am ; 58(4): 733-751, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32471541

RESUMO

Preoperative assessment with computed tomography (CT) is critical before transcatheter interventions for structural heart disease. CT provides information for device selection, device sizing, and vascular access approach. The interpreting radiologist must have knowledge of appropriate CT protocols, how and where to obtain the important measurements, and know additional imaging characteristics that are important to describe for optimal support of the interventionalist. CT is the modality of choice for pre-operative evaluation in patients undergoing transcatheter aortic valve replacement and left atrial appendage occlusion, and is also useful before transcatheter mitral valve replacement, which is an ongoing area of research.


Assuntos
Doenças das Valvas Cardíacas/diagnóstico por imagem , Doenças das Valvas Cardíacas/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Cuidados Pré-Operatórios , Tomografia Computadorizada por Raios X , Aorta/diagnóstico por imagem , Aorta/cirurgia , Humanos , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Planejamento de Assistência ao Paciente , Cuidados Pré-Operatórios/métodos , Cirurgia Assistida por Computador , Substituição da Valva Aórtica Transcateter/métodos
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