transcatheter aortic-valve implantation tavi oggi in toscana
DESCRIPTION
TRANSCATHETER AORTIC-VALVE IMPLANTATION TAVI oggi in Toscana . Sergio Berti Fondazione CNR- Regione Toscana “G. Monasterio ”, Ospedale del Cuore, Massa [email protected]. TAVI in Toscana: 3.500.000 abitanti 4 centri attivi. TAVI Indications. SEVERE AORTIC STENOSIS : - PowerPoint PPT PresentationTRANSCRIPT
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TRANSCATHETER AORTIC-VALVE IMPLANTATION
TAVI oggi in Toscana
Sergio BertiFondazione CNR- Regione Toscana “G.
Monasterio”, Ospedale del Cuore, [email protected]
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TAVI in Toscana: 3.500.000 abitanti 4 centri attivi
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TAVI Indications• SEVERE AORTIC STENOSIS :
AVA < 0,8 cm² (or AVA index < 0,5 cm²/m²) and
mean AVG > 40 mmHg or peak jet velocity > 4.0 m/sec
• CARDIAC SYMPTOMS: NYHA Functional Class ≥ II
HIGH SURGICAL RISK:
Clinical assessment of inoperability determinated by site cardiologist
and surgeon
Age > 75 years and Logistic Euro SCORE> 20
Age > 85 years and Logistic Euro SCORE> 10
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TAVI Indications• SEVERE AORTIC STENOSIS :
AVA < 0,8 cm² (or AVA index < 0,5 cm²/m²) and
mean AVG > 40 mmHg or peak jet velocity > 4.0 m/sec
• CARDIAC SYMPTOMS: NYHA Functional Class ≥ II
HIGH SURGICAL RISK:
Clinical assessment of inoperability determinated by site cardiologist
and surgeon
Age > 75 years and Logistic Euro SCORE> 20
Age > 85 years and Logistic Euro SCORE> 10
Bioprosthesis Dysfunction and High Surgical Risk
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Sapien Edwards CoreValve medtronic
TAVI regione Toscana anno 2010
Totale 175 casi
123
52
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Sapien Edwards
Tipologia di device utilizzati per singolo centro 2010
Sapien EdwardsCoreValve Medtronic
Sapien EdwardsCoreValve Medtronic
33
1
14
7
Sapien Edwards55
12
MASSA SIENA
FIRENZE PISA53
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Tipologia di accessi vascolari utilizzati per singolo centro
Transfemorale Transapicaletrans-succlavia
17
17
Transfemorale Transapicale17
1
3MASSA SIENA
FIRENZE PISA
Transfemorale transapicale
56
11
Transfemorale transapicale
0
40
13
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Valutazione preoperatoriaEmodinamista
Cardiochirurgo
Cardio-Anestesista
Ecocardiografista/clinicoFirenze Pisa Massa Siena
Accesso transfemorale
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Valutazione preoperatoriaEmodinamista
Cardiochirurgo
Cardio-Anestesista
Ecocardiografista/clinico
Emodinamista
Cardiochirurgo
Cardio-Anestesista
Ecocardiografista/clinico
Firenze Pisa Massa Siena
Firenze Pisa Massa Siena
Accesso transfemorale
Accesso transapicale
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Fase intraoperatoriaEmodinamista
Cardiochirurgo
Cardio-Anestesista
Ecocardiografista/clinicoFirenze Pisa Massa Siena
Accesso transfemorale
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Fase intraoperatoriaEmodinamista
Cardiochirurgo
Cardio-Anestesista
Ecocardiografista/clinico
Emodinamista
Cardiochirurgo
Cardio-Anestesista
Ecocardiografista/clinico
Firenze Pisa Massa Siena
Firenze Pisa Massa Siena
Accesso transfemorale
Accesso transapicale
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Impianto trans-succlavia: Valutazione pre-operatoria ed intervento
Emodinamista
Cardiochirurgo
Cardio-Anestesista
Ecocardiografista/clinico
Ch. Vascolare
Firenze Pisa Massa Siena
v. preoperatoria
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Impianto trans-succlavia: Valutazione pre-operatoria ed intervento
Emodinamista
Cardiochirurgo
Cardio-Anestesista
Ecocardiografista/clinico
Ch. Vascolare
Firenze Pisa Massa Siena
Firenze Pisa Massa Siena
v. preoperatoria
interventoEmodinamista
Cardiochirurgo
Cardio-Anestesista
Ecocardiografista/clinico
Ch. Vascolare
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Programmazione regionale
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Programmazione regionaleModalità di rimborso
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Programmazione regionaleModalità di rimborso
DRG104- 105
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TRANSCATHETER AORTIC-VALVE IMPLANTATION
TAVI oggi in Toscana
Sergio BertiFondazione CNR- Regione Toscana “G.
Monasterio”, Ospedale del Cuore, [email protected]