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Master Thesis

Évaluation des bioprothèses valvulaires aortiques implantées par voie artérielle transfémorale‎ : à propos des 25 premiers cas au CHU de Grenoble

Abstract : Three percent of the population aged > 75 years suffers from aortic stenosis, half of which is symptomatic. One third of these patients are not suitable candidates for surgery (contraindication or high risk of mortality). In the future, these patients may benefit from Transcatheter Aortic-Valve Implantation. The aim is to analyze the feasibility, safety and efficiency of the implementation of TAVI at Grenoble University Hospital in 25 successive cases. Implantation was 100% successful. Hospital complications included: 2 strokes (one fatal, one with sequelae) and 3 TIAs, 3 complete atrioventricular blocks (one pacemaker implantation), 2 hemorrages, 2 tamponades, and 5 transfusions. Average ICU stay was 2 days ± 1.8 (median = 1) and total hospital stay was 8.8 days ± 7.8 (median = 7). Two additional events were reported (implantation of pacemaker and ischemic stroke). The probability of survival and survival without MACCE (Major adverse cardiac / cerebrovascular events) at one year is 80% and 64% respectively, with the following predictive criteria pre-implantation: a low average gradient (p = 0.03), NYHA functional class III or IV (p <0.001), creatinine> 130 micromol / l (p = 0.04) and use of post -procedure intravenous diuretics (p = 0.04). This corresponds to the hemodynamic profile of heart failure in AS and low flow. Transfemoral TAVI is a feasible and effective approach in our medium-volume implantation center. This data is comparable with the French registries.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00626144
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Submitted on : Tuesday, January 3, 2012 - 8:51:06 AM
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Julien Caron. Évaluation des bioprothèses valvulaires aortiques implantées par voie artérielle transfémorale‎ : à propos des 25 premiers cas au CHU de Grenoble. Médecine humaine et pathologie. 2011. ⟨dumas-00626144⟩

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