Tom 13, Nr 3 (2018)
CHOROBY STRUKTURALNE SERCA
Opublikowany online: 2018-08-01
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Mechaniczna protekcja zatorowości mózgowej w TAVI
Kardiol Inwazyjna 2018;13(3):25-30.
Streszczenie
Ryzyko zdarzeń naczyniowo-mózgowych w ciągu 30 dni od zabiegu przezcewnikowej implantacji zastawki aortalnej (TAVI) wynosi około 5,5%. W dużym odsetku są one nieme klinicznie. Ryzyko zatorowości wiąże się z przejściem cewnikami przez zastawkę, predylatacją, pozycjonowaniem zastawki oraz jej uwolnieniem. Pociągnęło to za sobą rozwój nowych strategii mechanicznej ochrony mózgu przed potencjalnie zatorowym materiałem uwalnianym podczas zabiegów TAVI. Większość danych wskazuje, że stosowanie neuroprotekcji w zabiegach TAVI jest bezpieczne i znacznie zmniejsza liczbę zgonów lub udarów w porównaniu z grupami kontrolnymi bez protekcji mózgowej, niemniej aby udowodnić korzystną rolę neuroprotekcji podczas TAVI, potrzebne są dalsze, wieloośrodkowe, dobrze zaplanowane badania. Ochrona mózgu stanie się jeszcze ważniejsza, gdy wskazania do TAVI obejmą grupę pacjentów młodszych i/lub o niższym ryzyku zabiegowym.
Słowa kluczowe: transcatheter aortic valvae implantationcerebral embolismprotection devices
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