slide1 l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
“SOSTITUZIONE” PERCUTANEA DELLA VALVOLA AORTICA PowerPoint Presentation
Download Presentation
“SOSTITUZIONE” PERCUTANEA DELLA VALVOLA AORTICA

Loading in 2 Seconds...

play fullscreen
1 / 67

“SOSTITUZIONE” PERCUTANEA DELLA VALVOLA AORTICA - PowerPoint PPT Presentation


  • 195 Views
  • Uploaded on

“SOSTITUZIONE” PERCUTANEA DELLA VALVOLA AORTICA. Gennaro Santoro SOD ” Diagnostica e interventistica ” Dipartimento cardiologico e dei vasi AOU Careggi – Firenze Centro di riferimento regionale Cardiopatie Congenite in Età Adulta Follow up e Interventistica delle Valvulopatie.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about '“SOSTITUZIONE” PERCUTANEA DELLA VALVOLA AORTICA' - jaden


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

“SOSTITUZIONE” PERCUTANEA DELLA VALVOLA AORTICA

Gennaro Santoro

SOD ”Diagnostica e interventistica”

Dipartimento cardiologico e dei vasi

AOU Careggi – Firenze

Centro di riferimento regionale

Cardiopatie Congenite in Età Adulta

Follow up e Interventistica delle Valvulopatie

epidemiology
EPIDEMIOLOGY
  • AS is the most common form of the adult valvular heart disease
  • Population Incidence in USA of moderate-severe AS is 0,4% and in aged > 75 y is 2,8% (4% > 85 y)
  • 33% of patients with severe AS and NYHA fc III-IV did not undergo intervention (high risk).
slide7

KAN 1982

LABABIDI 1983

INOUE 1984

CRIBIER 1986

Cardiologia S.Luca Careggi Firenze

stenosi aortica calcifica

valvuloplastica percutanea

Stenosi aortica calcifica

Incremento area valvolare: da 0,4 a 0,9 cmq

Mortalità 3 –15%

Restenosi a 18 mesi 80%

stenosi aortica calcifica16
Stenosi aortica calcifica

Valvuloplastica percutanea

  • * ”PONTE ALLA CHIRURGIA:
  • -AREA VALVOLARE <0,4 CMQ,
  • -FE < 0,35
  • -IV classe NYHA
  • Pazienti in scompenso cardiaco refrattario e disfunzione multiorgano
  • Pazienti in shock
  • Pazienti in cui non è possibile la sostituzione
  • valvolare(?)
  • Paziente sintomatici che devono essere sottoposti ad interventi chirurgici urgenti per altra patologia
slide22
: Lancet. 2000 Oct 21;356(9239):1403-5. Related Articles, Links
    • Percutaneous replacement of pulmonary valve in a right-ventricle to pulmonary-artery prosthetic conduit with valve dysfunction.Bonhoeffer P, Boudjemline Y, Saliba Z, Merckx J, Aggoun Y, Bonnet D, Acar P, Le Bidois J, Sidi D, Kachaner J.
slide30

Percutaneous Heart Valve

  • PHV
  • Equine pericardium
  • Highly resistant balloon expandable stent
  • Optimal hemodynamics with durability > 5 years on bench testing
cribier edwards aortic phv
Cribier-Edwards Aortic PHV
  • Valve maintains circular geometry despite stenotic environment
  • Calcific native leaflets help secure valve and maintain fixation
tvt as osservazioni
TVT-AS OSSERVAZIONI
  • Noduli calcifici di grosse dimen sioni
  • Leak paravalvolare
  • Stabilità a lungo termine
  • Diametro dello sheat
  • Accesso
w hutchinski

For medical knowledge to progress we need both the optimist and the pessimist. Without the optimist there is no progress and without the pessimist there is non proof.

w.Hutchinski