Transkateterska implantacija aortalnog zalistka (TAVI) u liječenju bolesnika s teškom aortalnom stenozom: prikaz metode i rezultata u Kliničkome bolničkom centru Zagreb [Transcatheter aortic valve implantation (TAVI) in treatment of patients with sever aortic stenosis: method review and results from Zagreb University Hospital Center]

Bulum, Joško and Ostojić, Zvonimir and Strozzi, Maja and Šafradin, Ivica and Ivančan, Višnja and Šeparović-Hanževački, Jadranka and Rešković-Lukšić, Vlatka and Biočina, Bojan and Miličić, Davor (2017) Transkateterska implantacija aortalnog zalistka (TAVI) u liječenju bolesnika s teškom aortalnom stenozom: prikaz metode i rezultata u Kliničkome bolničkom centru Zagreb [Transcatheter aortic valve implantation (TAVI) in treatment of patients with sever aortic stenosis: method review and results from Zagreb University Hospital Center]. Liječnički vjesnik, 139 (3-4). pp. 82-90. ISSN 0024-3477

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Abstract

Aortic stenosis is the most common valvular heart disease in western countries. Prevalence is increasing with age and is between 2–4% in population aged 65 or above. Despite cardiac surgery, almost third of patients did not undergo surgery due to too high surgical risk and comorbidities. Transcatheter aortic valve implantation (TAVI) is globally approved method for treating sever aortic stenosis in patients whose surgical risk is too high or they are declared as inoperable due to some other medical condition. Using this method, artificial biological valve is implanted, on beating heart, just using catheters at the place of degenerate native valve. In UHC Zagreb TAVI program has started in 2012, and since then, 44 procedures were performed. All procedures, together with periprocedural management were done following recent recommendations and guidelines of the European and American heart societies. This has resulted in very favorable treatment success. In this article, the most important TAVI facts have been highlighted followed by analysis of our TAVI results from the UHC Zagreb.

Abstract in Croatian

Aortalna stenoza najčešća je bolest zalistaka u zemljama zapadne hemisfere. Njezina se prevalencija povećava sa starošću populacije te iznosi 2 – 4% u osoba starijih od 65 godina. Usprkos kardiokirurškoj operaciji gotovo trećina bolesnika nije operirana zbog visokog operativnog rizika i komorbiditeta. Transkateterska implantacija aortalnog zalistka (TAVI) danas je općepriznata metoda za liječenje teške aortalne stenoze kod bolesnika čiji je kardiokirurški rizik neprihvatljivo visok ili koji su iz nekoga drugog razloga proglašeni neoperabilnima. Tom se metodom, na kucajućem srcu, s pomoću katetera postavlja umjetna biološka valvula na mjesto degenerirane nativne valvule. U KBC-u Zagreb program TAVI provodi se od 2012. godine, od kada su učinjena 44 zahvata. Svi zahvati, kao i prijeoperacijske obrade, izvođeni su prema svim vrijedećim preporukama i smjernicama Europskog i Američkoga kardiološkog društva, što je rezultiralo jednakom uspješnošću zahvata. U ovom članku istaknute su najbitnije činjenice o metodi TAVI, nakon čega su prikazani rezultati KBC-a Zagreb.

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