INTERVENCION PERCUTANEA DE LA VALVULA AORTICA

Dr. Daniel Meneses Jefe Hemodinmica Hospital metropolitano Vivian Pellas. Managua, Nicaragua

VALVULOPLASTIA CON BALON

Valvuloplastia - mortalidad a 30 das = 14%

Mortalidad cumulativa despus la valvulopastia artica percutnea
Mortalidad total Aguda (<24h) Al salir del hospital A 30 das de seguimiento 17 (3%) 69 (10%) 92 (14%) Causas CV 16 (2%) 53 (8%) 71 (11%)

Complicaciones
Transfusin Muerte cardaca Ciruga vascular ACV Shock cardiognico Muerte no cardaca Infarto del miocardio Embolia sistmica Tamponada cardaca NTA Otra 0 20 40 60 80

Agudas (<24h) En el hospital

100 120

140 160

180 Nb pacientes (n=674)

NHLBI Balloon Valvuloplasty Registry. Circulation 1991;84:2383-97.

Valvuloplastia
Probabilidad de sobrevivencia actuarial
1.00

0.75

0.50

0.25
Solamente BAV BAV + AVR

0.00 0 1 2 3

n=123 n=42

60 35

31 30

14 solemente BAV 18 BAV +AVR

Lieberman EB et al. JACC 1995;26:1522-8.

Valvuloplastia
ACC/AHA guidelines

Class IIb

1. Aortic balloon valvotomy might be reasonable as a bridge to surgery in hemodynamically unstable adult patients with AS who are at high risk of AVR. (Level of Evidence: C) 2. Aortic balloon valvotomy might be reasonable for palliation in adult patients with AS in whom AVR cannot be performed because of serious comorbid conditions. (Level of Evidence: C)

ACC/AHA Guidelines. Valvular heart disease. JACC 2008;52:1-142.

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MUCHAS GRACIAS