Desfechos de curto e médio prazos de pacientes com e sem disfunção ventricular esquerda submetidos ao implante transcateter de prótese valvar aórtica

Verri, Paulo Henrique; Meneguz‐Moreno, Rafael Alexandre; Teixeira, Felipe Rodrigues da Costa; Etto, Juliana Paixão; Gomes, Marília Cristina Cunha; Jeronimo, Andreia Dias; Ramos, Auristela Isabel de Oliveira; Siqueira, Dimytri; Abizaid, Alexandre; Sousa, Amanda G. M. R.; Sousa, J. Eduardo

doi:10.1016/j.rbci.2015.12.011

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…Transcatheter aortic valve implantation (TAVI) is a relatively new medical procedure 1 and its long‐term impacts are still unknown, unlike conventional aortic valve replacement. Recently, TAVI has been suggested for patients with intermediate and low surgical risk 2,3 . Even after this procedure has become popular, some questions still remain.…”

Section: Introductionmentioning

confidence: 99%

Effect of percutaneous aortic valve position on stress map in ascending aorta: A fluid‐structure interaction analysis

2021

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Transcatheter aortic valve implantation (TAVI) is an increasingly widespread procedure. Although this intervention is indicated for high and low surgical risk patients, some issues still remain, such as prosthesis positioning optimization in the aortic annulus. Coaxial positioning of the percutaneous prosthesis influences directly on the aortic wall stress map. The determination of the mechanical stress that acts on the vascular endothelium resulting from blood flow can be considered an important task, since TAVI positioning can lead to unfavorable hemodynamic patterns, resulting in changes in parietal stress, such as those found in post‐stenotic dilatation region. This research aims to investigate the influence of the prosthetic valve inclination angle in the mechanical stresses acting in the ascending aortic wall. Aortic compliance and blood flow during cardiac cycle were numerically obtained using fluid structure interaction. The aortic model was developed through segmentation of a computed tomography image of a specific patient submitted to TAVI. When compared to standard position (coaxiality match between the prosthesis and the aortic annulus), the inclination of 4° directed to the left main coronary artery decreased the aortic wall area with high values of wall shear stress and pressure. Coaxial positioning optimization of percutaneous aortic prosthesis may decrease the high mechanical stress area. These changes may be important to reduce the aortic remodeling process, vascular calcification or even the prosthesis half‐life. Computational fluid dynamics makes room for personalized medicine, with manufactured prosthesis tailored to each patient.

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Section: Introductionmentioning

confidence: 99%

Effect of percutaneous aortic valve position on stress map in ascending aorta: A fluid‐structure interaction analysis

2021

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“…De um modo geral, este procedimento apresenta-se como exitoso, com baixos índices de mortalidade. Entretanto, este índice pode alcançar valores alarmantes de até 50% (Culliford et al, 1991) (Verri et al, 2015). O implante da prótese valvar é geralmente realizado com acesso percutâneo à artéria femoral do paciente, mas também pode ser realizado pelas vias transapical ou transaórtica através de uma pequena toracotomia (Figura 2.4) (Lifesciences, 2018).…”

Section: Implante Percutâneo De Prótese Valvarunclassified

Estudo Do Escoamento Em Modelo De Aorta Utilizando a Velocimetria Por Imagens Estereoscópicas De Partículas

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“…Uma das possibilidades de diminuir o risco da cirurgia é PUC-Rio -Certificação Digital Nº 1513085/CA por intermédio do procedimento de implante da prótese valvar aórtica com a utilização de cateteres (Transcatheter aortic valve implantation, TAVI) (Cribier et al, 2002). Este tipo de procedimento é recomendado para pacientes que não são aptos para a cirurgia convencional (Verri et al, 2015), porém, no ano 2019 tem sido usado o procedimento TAVI em paciente de baixo risco cirúrgico (Popma et al, 2019) . No procedimento TAVI a prótese valvar é conduzida através de um cateterbalão que percorre a artéria femoral (ou transapical, transaórtica) até ser implantada no ânulo aórtico.…”

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Estudo Numérico Da Influência Da Inclinação Da Prótese Valvar Aórtica No Fluxo Sanguíneo Em Aorta Ascendente

AGUILAR¹

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Desfechos de curto e médio prazos de pacientes com e sem disfunção ventricular esquerda submetidos ao implante transcateter de prótese valvar aórtica

Cited by 4 publications

References 20 publications

Effect of percutaneous aortic valve position on stress map in ascending aorta: A fluid‐structure interaction analysis

Effect of percutaneous aortic valve position on stress map in ascending aorta: A fluid‐structure interaction analysis

Estudo Do Escoamento Em Modelo De Aorta Utilizando a Velocimetria Por Imagens Estereoscópicas De Partículas

Estudo Numérico Da Influência Da Inclinação Da Prótese Valvar Aórtica No Fluxo Sanguíneo Em Aorta Ascendente

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