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Valvula aortica sin corazon abierto
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Valvula aortica sin corazon abierto

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Los dispositivos artificiales se colocan a través de la arteria femoral o mediante una pequeña incisión en las costillas del paciente. 

Un enfoque innovador para la implantación de una nueva válvula cardiaca aórtica sin cirugía a corazón abierto se ofrece a los pacientes en el Hospital NewYork-Presbyterian. Conocido como PARTNER (Placement of AoRTic trNscathetER valves), este estudio se centra en pacientes en los que la cirugía de reemplazo de válvulas cardiacas a corazón abierto supone un alto riesgo o no es adecuado. Para evitar estos riesgos, la válvula se coloca a través de la arteria femoral o con una pequeña incisión en las costillas del paciente.
Actualmente, unas 200.000 personas de Estados Unidos necesitan una nueva válvula cardiaca, pero casi la mitad de ellos no la pueden recibir por distintas razones. "Esta tecnología podría salvar las vida de miles de pacientes con enfermedades cardiacas que no tienen otras opciones terapéuticas", explica el doctor Martin Leon, principal investigador del estudio y director asociado del Cardiovascular Interventional Therapy (CIVIT), de la Universidad de Columbia.

Este nuevo avance, elaborado con tejido de pericardio bovino cosido a mano a una estructura de metal, se implanta a través de un catéter mediante dos métodos: mediante el acceso al corazón a través de la arteria femoral de la pierna del paciente, o a través de una pequeña incisión entre las costillas y su ventrículo izquierdo. Ambos procedimientos se realizan en un corazón que late, sin necesidad de bypass cardiopulmonar y sus riesgos asociados.

"El estudio puede mostrar que esta válvula de sustitución es una alternativa segura y efectiva a la cirugía abierta, que sigue siendo el 'estándar de oro' para la mayoría de los pacientes", asegura el doctor Craig Smith, investigador principal junto a Leon y director de cirugía cardiotorácica en el hospital NewYork-Presbyterian.


Los procedimientos del implante de esta válvula dura en torno a 90 minutos, en comparación con las cuatro o seis horas de operación a corazón abierto. Además, la operación a corazón abierto puede requerir de dos a tres meses de recuperación, a diferencia de los pocos días necesarios para esta nueva válvula. Todo esto se suma a los peligros de la operación a corazón abierto, en la que el cirujano corta a través del esternón, detiene el corazón, quita la válvula y la reemplaza.

El PARTNER es un estudio prospectivo con dos brazos de tratamiento. En el brazo de cirugía, los pacientes son asignados al azar a recibir la nueva válvula cardiaca o la cirugía a corazón abierto. En el brazo médico, los pacientes que se consideran no aptos para la cirugía a corazón abierto son asignados al azar entre esta válvula o un tratamiento médico adecuado. medicinaXXI
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