Método de implantación de válvula aórtica transcatéter vs. Cirugía convencional asociado a estenosis aórtica severa: Revisión sistemática

Abstract

Introduction: Aortic stenosis is one of the most frequent cardiac structural pathologies related to aging and calcification, it occurs frequently in the elderly, with a prevalence of 3-6% in patients > 65 years of age. There is a predominance in men, representing 70.2%, while in women it is 29.8%. This valve disease initially produces symptoms such as angina, syncope, fainting, evident systolic murmur in the aortic focus, and eventually leads to heart failure, which determines its treatment and classification into surgical risk groups. This has prompted the research and development of new minimally invasive techniques, such as transcatheter aortic valve implantation (TAVR), which replace outdated more invasive methods and are compared with fewer complications and mortality rates in the short and long term. This is valid regardless of the patient's age or surgical risk group.

Methodology: a systematic bibliographic review was carried out where articles published in English in different databases of scientific interest such as PubMed, Scopus and Web of Science were selected, carried out in humans during the last 5 years, meta-analysis type publications were taken, case reports, randomized clinical trials, comparative and observational studies, the data will be expressed in simple tables for analysis and review.

Results: It was found that the selection of patients by criteria such as a "Logarithm of the European System for Cardiac Operative Risk Evaluation" (logEuroSCORE) < 20%, a "Society of Thoracic Surgeons Risk Score" (STS SCORE) > 4% and prior evaluation of the presence of type 2 diabetes mellitus, body mass index (BMI), and dialysis chronic renal failure are important factors in determining the success of TAVR or SAVR.

Conclusion: It is established that there is no clear superiority between both techniques, however, TAVR could be more beneficial in patients with a surgical risk considered intermediate or high, while SAVR could be more appropriate for younger patients.