Perkutana implantacija aortne valvule u usporedbi s kirurškom zamjenom valvule u bolesnika niskog rizika

master's thesis

• Title (english): Comparison of percutaneous implantation versus surgical replacement of aortic valve in low-risk patients
• Author: Katarina Matić
• Mentor: Vjekoslav Radeljić (mentor)
• Committee member: Matias Trbušić (predsjednik povjerenstva)
• Committee member: Martina Lovrić Benčić (član povjerenstva)
• Committee member: Vjekoslav Radeljić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Aortalna stenoza (AS) najčešća je bolest srčanih zalistaka, a prevalencija joj svake godine raste kao posljedica starenja stanovništva. Zamjena nativnog aortalnog zaliska definitivna je metoda liječenja teške simptomatske aortalne stenoze. Dugi niz godina kirurška zamjena aortalnog zaliska (SAVR) bila je jedina dostupna metoda liječenja za pacijente s teškom aortalnom stenozom. Razvoj minimalno invazivne kirurgije i perkutane implantacije aortalne valvule započeo je revoluciju u liječenju pacijenata s teškom AS-om. U zadnjem desetljeću, transkateterska implantacija aortalne valvule (TAVI) etablirala se kao učinkovita terapijska metoda kod inoperabilnih pacijenata te pacijenata s visokim i umjerenim operativnim rizikom, a od nedavno indikacije su proširene na pacijente s niskim operativnim rizikom. Minimalna invazivnost zahvata, napredak u tehnici i iskustvo operatera omogućili su tako brzi razvoj i proširivanje indikacija za TAVI. Svaka zamjena aortalnog zaliska nosi rizik od komplikacija, a obje metode imaju svoja ograničenja . Dok su podaci o dugoročnim kliničkim ishodima i izdržljivosti bioloških valvula nakon SAVR dobro poznati, nedostatak istih za pacijenta niskog rizika podvrgnute TAVI-u predstavlja glavno ograničenje primjene TAVI metode kod pacijenta niskog rizika. Daljnja istraživanja i dugoročno praćenje niskorizičnih pacijenata liječenih TAVI-em ostavljaju prostor za daljnje proširivanje indikacija i pomicanje paradigme u liječenju pacijenata s teškom aortnom stenozom.

Abstract (english)

Aortic stenosis (AS) is the most common heart valve disease and its prevalence is increasing every year as a result of the aging of the population. Replacement of the native aortic valve is the definitive treatment method for severe symptomatic AS. For many years, surgical aortic valve replacement (SAVR) was the only available treatment method. The development of minimally invasive surgery and percutaneous aortic valve implantation revolutionized the treatment of patients with severe AS. In the last decade, transcatheter aortic valve implantation (TAVI) has established as an effective therapeutic method in inoperable patients, patients with high and moderate operative risk, while recently the indications have been extended to patients with low operative risk. The minimal invasiveness of the procedure, advances in technique and the experience of the operator have enabled the rapid development and expansion of indications for TAVI. Every aortic valve replacement method carries risks and has a set of complications accompanied by their limitations. While data on the long-term clinical outcomes and durability of biological valves after SAVR are well known, the lack of data on the low-risk patient undergoing TAVI represents a major limitation to the application of the TAVI method in the low-risk patient. Further research and long-term follow-up of low-risk patients treated with TAVI leave space for further expanding the indications and shifting the paradigm in the treatment of patients with severe aortic stenosis.

• Keywords: aortna stenoza; transkateterska zamjena aortalne valvule; kirurška zamjena aortalne valvule; pacijenti niskog rizika
• Keywords (english): aortic stenosis; transcatheter aortic valve replacement; surgical aortic valve replacement; low risk
• Language: croatian
• URN:NBN: urn:nbn:hr:105:393249
• 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: 2023-01-19 09:02:36