ACQUIRED AORTIC VALVE DISEASES

Stečene bolesti aortalne valvule primarno su degenerativne bolesti s prevalencijom pojave u bolesnika starijih od 65 godina, a najčešće se prezentiraju u obliku aortalne regurgitacije te aortalne stenoze (2 – 3% incidencije u osoba starijih od 65 godina). Potonja spomenuta stanja hemodinamički opterećuju lijevi ventrikul dovodeći do disfunkcije istog, zatajenja srca i/ili iznenadne smrti. Neki od najčešćih uzroka stečenih bolesti aortalnih zalistaka uključuju endokarditis, reumatoidne bolesti, aterosklerozu, deformacije zalistaka, hipertenziju, a mogu biti posljedica i postoperativnih komplikacija te kolagenoza koje progresijom zahvaćaju srčane zaliske. Uobičajena simptomatologija bolesti obilježena je simptomima i znakovima poput angine, dispneje, zaduhe pri fizičkom naporu i patognomičnih srčanih šumova te ostalih znakova zatajenja lijevog ventrikula. Kirurški pristup stanjima podrazumijeva jedino definitivno i trajno rješenje istih, no problem procjene točnog trenutka u kojem izvesti operaciju predstavlja itekako rizik. Minimalno invaznivni postupci, poput TAVR i TAVI, ne zahtijevaju otvaranje prsnog koša te samim time ne predstavljaju toliki stres na psihičko stanje pacijenta, a posljedično dovode i do manje postoperativnih komplikacija te bolje prognoze. Takvi postupci predstavljaju napredak i daju prostor za napredovanje. U ovoj retrospektivnoj studiji, proučili smo 51 pacijenta sa stečenom aortalnom stenozom koji su zaprimljeni i liječeni na Zavodu za kardijalnu kirurgiju, Klinike za kirurgiju, Kliničkog Bolničkog Centra (KBC) Rijeka između siječnja 2012. godine i prosinca 2016. godine. Pacijenti su pokazali slične epidemiološke karakteristike, dobno-spolnu raspodjelu incidencije i sličnu stopu mortaliteta podacima pronađenim u nekoliko drugih studija i medicinskoj literatureAcquired aortic valvular diseases are primarily degenerative in nature and most often present in patients over the age of 65 years. The 2 main aortic valve diseases include aortic regurgitation and aortic stenosis which is the most prevalent valvular disease in the elderly, occurring in roughly 2-3% of patients over the age of 65 years. Both conditions place a hemodynamic burden on the left ventricle which consequently can lead to left ventricular dysfunction, cardiac failure or sudden death without proper and timely intervention. The causes of acquired aortic valve diseases include infective endocarditis, rheumatic diseases, atherosclerosis, valvular malformations, hypertension, collagen valvular diseases and postoperative complications. Most patients usually present with signs of angina, exertional dyspnea, exercise intolerance, pathognomonic cardiac murmurs and other symptoms of left ventricular failure. Surgical treatment is the only definitive treatment for aortic valve diseases with the major challenge being the proper timing of the surgical procedure. The invention of minimally invasive procedures such as TAVR and TAVI that don’t put patients under the stress of open heart surgery has led to better prognosis and lesser postoperative complications and thus has led to major steps forward in the treatment of these conditions. In this retrospective study, we looked at 51 patients with acquired aortic stenosis admitted and treated na Zavodu za kardijalnu kirurgiju, Klinike za kirurgiju, Kliničkog Bolničkog Centra (KBC) Rijeka between January 2012 and December 2016. The patients showed similar epidemiological characteristics, incidence of distribution in terms gender and age and also a similar mortality rate to data from several other studies and medical literature