RESUMO
BACKGROUND: Incidentally discovered severe calcified ascending aorta (CAA) is a major challenge faced by surgeons during cardiac surgery. The aim of this study was to evaluate the outcome in patients undergoing cardiac surgery in this condition with the additional replacement of the CAA. METHODS: A retrospective study on a cohort of 74 patients (28.4% females; mean age: 73 ± 7 years) underwent cardiac surgery and initial replacement of an incidentally discovered CAA using moderate hypothermic circulatory arrest. A control group was matched according to age, gender, and procedure. RESULTS: No significant differences were noted with regard to preoperative risk factors. Due to the additional replacement of CAA, the extracorporeal circulation and cross-clamping time were significantly longer in the study group (p < 0.001). Postoperatively, no significant differences in complications were observed between the groups. There was no significant difference in regard to incidence of neurologic adverse events (5.4 vs. 2.7%; p = 0.68) or 30-day mortality (6.7 vs. 4.1%; p = 0.72). CONCLUSION: Our study showed that the initial replacement of incidental CAA in patients undergoing cardiac surgery was not associated with increased risks for neurologic adverse events and mortality.
Assuntos
Doenças da Aorta/cirurgia , Implante de Prótese Vascular , Procedimentos Cirúrgicos Cardíacos , Achados Incidentais , Calcificação Vascular/cirurgia , Idoso , Idoso de 80 Anos ou mais , Doenças da Aorta/diagnóstico , Doenças da Aorta/mortalidade , Implante de Prótese Vascular/efeitos adversos , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Procedimentos Cirúrgicos Cardíacos/mortalidade , Bases de Dados Factuais , Feminino , Humanos , Masculino , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Calcificação Vascular/diagnóstico , Calcificação Vascular/mortalidadeRESUMO
Over the last two decades, transcatheter devices have been developed to repair or replace diseased mitral valves (MV). Transcatheter mitral valve repair (TMVr) devices have been proven to be efficient and safe, but many anatomical structures are not compatible with these technologies. The most significant advantage of transcatheter mitral valve replacement (TMVR) over transcatheter repair is the greater and more reliable reduction in mitral regurgitation. However, there are also potential disadvantages. This review introduces the newest TMVr and TMVR devices and presents clinical trial data to identify current challenges and directions for future research.