Transkateterska implantacija aortalne valvule

master's thesis

• Title (english): Transcatheter aortic valve implantation
• Author: Ljuba Doko
• Mentor: Boris Starčević (mentor)
• Committee member: Igor Rudež (predsjednik povjerenstva)
• Committee member: Boško Skorić (član povjerenstva)
• Committee member: Boris Starčević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Aortalna stenoza (AS) najčešća je valvularna bolest sa sve većom incidencijom među stanovništvom zbog starenja populacije. Nakon pojave simptoma, AS povezana je s visokom stopom smrtosti ako se ne liječi. Godinama je kirurška zamjena aortalnog zaliska (SAVR) bila jedina metoda liječenja AS-e, no u jedne je trećine bolesnika kontraindicirana zbog popratnih bolesti i lošeg općeg stanja. Kao alternativna metoda kirurškoj, razvila se metoda minimalno invazivnog pristupa. Transkateterska implantacija aortalne valvule (TAVI) je terapijska metoda liječenja AS-e implantacijom bioprostetičkog aortalnog zaliska kateterom kroz femoralnu arteriju ili nekim od alternativnih pristupa bez otvorene operacije srca i uporabe izvantjelesne cirkulacije. Postala je etabliran i učinkovit terapijski postupak u neoperabilnih te srednje i visoko rizičnih bolesnika sa simptomatskom AS. Poboljšanja u proceduralnoj tehnici i iskustvu operatera pridonjela su smanjenju proceduralnih komplikacija koje su bile najveće limitacije metode. Uspjeh u proceduri uvelike ovisi o temeljitom preproceduralnom procjeni svakog pojedinog kandidata. Kirurška i transkateterska metoda imaju prednosti i mana koje treba uzeti u obzir pri odabiru preferirane intervencije. Odluku o odgovarajućoj intervenciji, najboljem implantacijskom pristupu te odabiru bioprostetičke aortalne valvule u konačnici donosi multidisciplinarni „heart-team“.

Abstract (english)

Aortic stenosis (AS) is the most common valvular disease with an increasing incidence among the population due to population aging. After the onset of symptoms, AS is associated with a high mortality rate if left untreated. For years,
surgical replacement of the aortic valve (SAVR) was the only method of treating AS, but in one-third of patients it was contraindicated due to comorbidities and poor general condition. As an alternative method to surgery, a method of minimally
invasive approach has been developed. Transcatheter aortic valve implantation (TAVI) is a therapeutic method of treating AS by delivering a bioprosthetic aortic valve by catheter through the femoral artery or some of the alternative approaches
without open heart surgery and the use of extracorporeal circulation. It has become an established and effective therapeutic procedure in inoperable and medium and high risk patients with symptomatic AS. Improvements in procedural technique and operator experience contributed to the reduction of procedural complications that were the greatest limitations of the method. Success in the procedure largely depends on a thorough pre-procedural assessment of each individual candidate. The surgical and transcatheter methods have advantages and disadvantages that should be considered when selecting the preferred intervention. The decision on the appropriate intervention, the best implantation approach and the selection of the
bioprosthetic aortic valve is ultimately made by the multidisciplinary "heart-team".

• Keywords: transkateterska implantacija aortalne valvule; aortalna stenoza; interventna kardiologija
• Keywords (english): transcatheter aortic valve implantation; aortic stenosis; interventional cardiology
• Language: croatian
• URN:NBN: urn:nbn:hr:105:196761
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-03-17 09:56:39