Preoperativna evaluacija bolesnika za proceduru transarterijske implantacije aortnog zaliska

master's thesis

• Title (english): Preoperative evaluation of patients for transarterial aortic valve implantation (tavi)
• Author: Ana Grabić
• Mentor: Željko Sutlić (mentor)
• Committee member: Hrvoje Gašparović (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Željko Sutlić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Transkateterska implantacija aortnog zaliska je minimalno invazivna metoda zamjene aortnog zaliska kod visoko rizičnih pacijenata. Prisutna je u kardijalnoj kirugiji više od desetljeća i ostvaruje povoljne rezultate. Njen razvoj se temelji ne samo na vještinama operatera nego i na usavršavanju proceduralne tehnologije i razvoju dijagnostičkih alata. Ovaj pristup liječenja zahtjeva suradnju mnogih subspecijalosti medicine ako je cilj uspješna izvedba i povećana kvaliteta života pacijenata. Osim izvedbe zahvata, najvažnije je učiniti pravilan odabir pacijenata koji zadovoljavaju kriterije za pogodnu i indiciranu izvedbu zahvata.
U ovom radu prikazat ćemo složenu mrežu odabira kandidata za TAVI proceduru. Multimodalni pristup označava preoperacijsku evaluaciju koja zahtjeva sinergiju različitih dijagnostičkih alata, ponajprije iz područja djelovanja internista kardiologije i iskusnog radiologa s izvrsnim poznavanjem kardiovaskularne anatomije i patologije. Prvo ćemo govoriti o indikacijama za proceduru, strukturi pacijenata i stupnju bolesti aortnog zaliska, a zatim se fokusirati na dostupne metode obrade. Iznijet ćemo uočene nedostatke u obradi pacijenata i nepredviđenim propustima koje u budućnosti valja spriječiti. Na kraju ćemo obratiti pozornost na dva učestala komorbiditeta koje povezujemo s ovom ciljanom populacijom kardiokirurških bolesnika.

Abstract (english)

Transcatheter aortic valve implantation is a minimal invasive method of aortic valve replacement in high-risk patients. It has been present in cardiac surgery over a decade and achieves unexpected results. Its development is based not only on a surgeon's skills but also on the improvement of procedural technology and development of diagnostic tools.
This approach to the treatment requires cooperation of many subspecialties of medicine if the goal is successful performance and increased quality of patient's life. Apart from the performance of the procedure, it is very important to make a good selection of patients who meet the criteria for suitable and indicated procedure.
In this paper we will show a complex network of candidate selection for TAVI procedure. Multimodal access indicates preoperative evaluation which requires synergy of diagnostic tools spectrum, primarily from -cardiology internist domain and experienced radiologist with excellent the knowledge in cardiovascular anatomy and pathology. We will first discuss the procedure indications, patient’s structure and stages of the aortic valve disease, and then focus on available imaging methods. We will outline observed deficiencies in a patient's evaluation and oversights which should be prevented in the future. In the end we will pay attention to two common comorbidities which are associated with this target population of cardiac patients.

• Keywords: transkateterska implantacija aortnog zaliska; kardijalna kirugija; odabir kandidata; multimodalni pristup
• Keywords (english): transcatheter aortic valve implantation; cardiac surgery; patient selection; multimodal access
• Language: croatian
• URN:NBN: urn:nbn:hr:105:381369
• 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: 2017-08-23 07:44:42