Predictores de cambio en la función ventricular izquierda posterior a implante valvular aórtico transcateter comparado con reemplazo valvular aórtico quirúrgico en el hospital universitario fundación Cardioinfantil instituto de cardiología – Bogotá

Abstract

Objectives: To identify predictors of left ventricular function recovery and to compare echocardiographic findings in patients with critical aortic stenosis following surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI).

Methods: Forty-four patients treated by SAVR were compared with 34 TAVI patients, echocardiographic data were retrospectively obtained before intervention and pre - discharge.

Results: We retrospectively analysed the FCI - IC patients, from 2009 – 2015 (n = 78 patients, mean age 70,29 ±11,63, logistic EuroSCORE 3,75 (3-8,55) SAVR and 20,4 (15,47-23,32) TAVI. Both groups showed a decrease in aortic valve gradients, more in TAVI patients, peak transaortic gradient (24,5 vs 18,5, p=0,001) mean (14 vs 10, p=0,002). Compared with SAVR, TAVI resulted in a greater number of patients with aortic regurgitation (47,1% vs 2,3% p=0,000). In total, 61.5% showed early improvement in ventricular function, the predictor of which was in severe left ventricular funtion a high left ventricular mass index.

Conclusions: Transcatheter aortic valve implantation is an alternative to surgical aortic valve replacement in patients with aortic stenosis and high surgical risk. Early postoperative recovery of left ventricular function was associated in severe left ventricular funtion to high left ventricular mass index.