Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic

İnce, İlker; AKSOY, MEHMET; SEVİMLİ, Serdar; Ahiskalioglu, Ali; ÇOLAK, Abdurrahim; Dogan, Nazim

Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic

Mehmet AKSOY, (Atatürk Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Erzurum, Türkiye)

İlker İNCE, (Atatürk Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Erzurum, Türkiye)

Ali AHISKALIOĞLU, (Atatürk Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Erzurum, Türkiye)

Nazım DOĞAN, (Atatürk Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Erzurum, Türkiye)

Abdurrahim ÇOLAK, (Atatürk Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Erzurum, Türkiye)

Serdar SEVİMLİ (Atatürk Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Erzurum, Türkiye)

Eurasian Journal of Medicine

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Yıl: 2015 Cilt: 47 Sayı: 2 Sayfa Aralığı: 91 - 98 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic

Öz:

Amaç: Bu çalışmanın amacı, cerrahi aort kapak replasmanı (SAVR)için yüksek risk taşıyan hastalarda yeni bir teknoloj i olan transkateteraort kapak implantasyonunun, (TAVI) kliniğimizdeki ilk uygulamalarını ve erken dönem sonuçlarını ortaya koymaktır. Gereç ve Yöntem: Ocak 2010 ve Aralık 2012 tarihleri arasında, şiddetli aort darlığı tanısı almış olup, cerrahi için yüksek riske sahip olmalarınedeniyle (EuroSCORE II: 5,58±4,20) kliniğimizde TAVI uygulanan 25hasta (16 erkek, 9 bayan; ortalama yaş: 74,04±8,86 yıl) değerlendirildi. Hastaların demografik ve klinik özellikleri, anestezi yönetimi, preve post-operatif dönemlerdeki komplikasyonlar ile ilk 30 gün ve altıaydaki mortalite oranları kaydedildi. Bulgular: Tüm hastalarda Edwards SAPIEN Valve protez transfemoralyaklaşımla (10 hastada perkutanöz, 15 hastada cerrahi yöntemle) yerleştirildi. Tüm hastalarda TAVI işlemi genel anestezi altında yapıldı vetransözefagial ekokardiyografi tüm hastalara uygulandı. TAVI işlemininbaşarı oranı %100 idi. İşlem süresince mortalite ve ciddi komplikasyonizlenmedi. Üç hastada femoral arterde sınırlı disseksiyon görüldü, ancak distal perfüzyonun iyi olması nedeniyle herhangi bir müdahalegerekmedi. Uzun süreli atriyoventriküler blokaj nedeniyle dört hastaya kalıcı pacemaker takıldı. İşlem sonrası, tüm hastalar Yoğun BakımÜnitesine (YBÜ) gönderildi ve tüm hastalar YBÜde ekstübe edildi.Ortalama mekanik ventilasyon süresi (dakika): 166,20±39,32, ortalamayoğun bakımda kalış süresi (gün): 5,64±2,99 ve ortalama hastanedekalış süresi (gün): 11,92 ±5,54 idi. Postoperatif birinci gün, bir hastadaakut renal yetmezlik ve iki hastada inme izlendi. İlk 30 gündeki mortalite oranı %4 ve ilk 6 aydaki mortalite oranı %16 olarak bulundu. Sonuç: Transkateter aort kapak implantasyonu, ciddi aort darlığıolup SAVR için yüksek risk taşıyan hastalarda mükemmel bir seçenektir. Enstitümüzde, TAVI uygulanan hastalardaki işlem başarısı vekısa dönem sonuçlarının Türkiyedeki ve dünyadaki diğer çalışmalarabenzer olduğu bulundu.

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Transkateter Aort Kapak Implantasyonu: Kliniğimizdeki İlk Uygulamalar ve Erken Dönem Sonuçları

Öz:

Objective: The objective of this study is to evaluate the first applications and short term outcomes of transcatheter aortic valve implantation (TAVI) in our clinic, which is a new technology for the patientswith high risk for surgical aortic valve replacement (SAVR). Materials and Methods: Between January 2010 and December 2012,twenty five patients (16 males, 9 females; mean age 74.04±8.86 years)diagnosed with severe aortic stenosis, who were at high risk for surgery(EuroSCORE II: 5.58±4.20) and underwent TAVI in our clinic, were evaluated. The demographic and clinical characteristics of patients, anaestheticmanagement, complications during pre- and post-operative periodsand the mortality rate in the first 30 days and six months were recorded. Results: Edwards SAPIEN Valve prostheses were implanted by transfemoral approach (percutaneously in 10 patients and surgically in15 patients) in all patients. The TAVI procedure was performed under general anaesthesia. The success rate of the TAVI procedure was100%. Three patients had limited dissection of the femoral artery;however, intervention was not needed due to good distal perfusionrate. Permanent pacemaker was implanted to four patients becauseof long-term atrioventricular blockage. After the procedure, all pa- tients were transferred to the Intensive Care Unit (ICU) and all patientswere extubated in the ICU. The mean mechanical ventilation duration(minutes) was 166.20±39.32, the mean critical care unit stay (day) was5.64±2.99 and the mean hospital stay (day) was 11.92±5.54. Acuterenal failure was observed in one patient and stroke was observed intwo patients on the first postoperative day. The mortality rate in thefirst 30 days and 6 months was found to be 4% and 16%, respectively. Conclusion: Transcatheter aortic valve implantation is a great option forpatients with severe aortic stenosis who are at high risk for SAVR. In ourinstitute, procedural success and short term outcomes for patients underwent TAVI were found to be similar to the other studies in the nationaland international literature.

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	AKSOY M, İnce İ, Ahiskalioglu A, Dogan N, ÇOLAK A, SEVİMLİ S (2015). Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic. , 91 - 98.
Chicago	AKSOY MEHMET,İnce İlker,Ahiskalioglu Ali,Dogan Nazim,ÇOLAK Abdurrahim,SEVİMLİ Serdar Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic. (2015): 91 - 98.
MLA	AKSOY MEHMET,İnce İlker,Ahiskalioglu Ali,Dogan Nazim,ÇOLAK Abdurrahim,SEVİMLİ Serdar Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic. , 2015, ss.91 - 98.
AMA	AKSOY M,İnce İ,Ahiskalioglu A,Dogan N,ÇOLAK A,SEVİMLİ S Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic. . 2015; 91 - 98.
Vancouver	AKSOY M,İnce İ,Ahiskalioglu A,Dogan N,ÇOLAK A,SEVİMLİ S Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic. . 2015; 91 - 98.
IEEE	AKSOY M,İnce İ,Ahiskalioglu A,Dogan N,ÇOLAK A,SEVİMLİ S "Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic." , ss.91 - 98, 2015.
ISNAD	AKSOY, MEHMET vd. "Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic". (2015), 91-98.

APA	AKSOY M, İnce İ, Ahiskalioglu A, Dogan N, ÇOLAK A, SEVİMLİ S (2015). Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic. Eurasian Journal of Medicine, 47(2), 91 - 98.
Chicago	AKSOY MEHMET,İnce İlker,Ahiskalioglu Ali,Dogan Nazim,ÇOLAK Abdurrahim,SEVİMLİ Serdar Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic. Eurasian Journal of Medicine 47, no.2 (2015): 91 - 98.
MLA	AKSOY MEHMET,İnce İlker,Ahiskalioglu Ali,Dogan Nazim,ÇOLAK Abdurrahim,SEVİMLİ Serdar Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic. Eurasian Journal of Medicine, vol.47, no.2, 2015, ss.91 - 98.
AMA	AKSOY M,İnce İ,Ahiskalioglu A,Dogan N,ÇOLAK A,SEVİMLİ S Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic. Eurasian Journal of Medicine. 2015; 47(2): 91 - 98.
Vancouver	AKSOY M,İnce İ,Ahiskalioglu A,Dogan N,ÇOLAK A,SEVİMLİ S Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic. Eurasian Journal of Medicine. 2015; 47(2): 91 - 98.
IEEE	AKSOY M,İnce İ,Ahiskalioglu A,Dogan N,ÇOLAK A,SEVİMLİ S "Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic." Eurasian Journal of Medicine, 47, ss.91 - 98, 2015.
ISNAD	AKSOY, MEHMET vd. "Transcatheter Aortic Valve Implantation: First Applications and Short Term Outcomes in Our Clinic". Eurasian Journal of Medicine 47/2 (2015), 91-98.