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Vol 81, Supp. I (2023): Zeszyty Edukacyjne 1/2023
Opinie i stanowiska ekspertów
Published online: 2023-09-27

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Przezcewnikowa implantacja zastawki aortalnej w leczeniu dysfunkcyjnych bioprotez chirurgicznych i przezcewnikowych. Opinia ekspertów Asocjacji Interwencji Sercowo-Naczyniowych Polskiego Towarzystwa Kardiologicznego

Zenon Huczek1, Marcin Protasiewicz2, Maciej Dąbrowski3, Radosław Parma4, Damian Hudziak5, Piotr Olszówka6, Radosław Targoński7, Kajetan Grodecki1, Marek Frank8, Piotr Scisło1, Paweł Kralisz9, Jarosław Trębacz10, Jerzy Sacha11, Krzysztof Wilczek1213, Andrzej Walczak14, Grzegorz Smolka4, Paweł Kleczyński1015, Krzysztof Milewski16, Michał Hawranek1213, Janusz Kochman1, Maciej Lesiak17, Dariusz Dudek1819, Adam Witkowski3, Jacek Legutko1015, Stanisław Bartuś2021, Radosław Wilimski22, Wojciech Wojakowski4, Marek Grygier17
DOI: 10.33963/v.kp.96985

Abstract

Ponad 15-letnie doświadczenie i wyniki dużych badań obserwacyjnych, na podstawie których tworzone są wytyczne, wskazują na bezpieczeństwo i skuteczność zabiegów przezcewnikowej implantacji „zastawki w zastawkę” (ViV-TAVI, valve-in-valve transcatheter aortic valve implantation), zmniejszając tym samym potrzebę reoperacji u pacjentów wysokiego ryzyka. Oczekuje się, że liczba zabiegów ViV-TAVI w Polsce, szacowana na około 2% wszystkich przezcewnikowej implantacji zastawki aortalnej w 2020 roku, będzie rosła. Niniejszy dokument ma na celu przegląd aspektów proceduralnych ViV-TAVI, w tym odpowiednich metod planowania przedzabiegowego, sposobów optymalizacji wyników hemodynamicznych i ograniczania ryzyka okluzji tętnic wieńcowych. Dokument zawiera również wstępny przegląd wskazań i wytycznych dotyczących ponownego zabiegu TAVI (re-do TAVI) u pacjentów ze zdegenerowanymi zastawkami przezcewnikowymi.

Keywords: bioproteza aortalnadegeneracjaokluzja wieńcowa„zastawka w zastawkę”

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