Pedoman Klinis Transcatheter Aortic Valve Implantation (TAVI)

Oleh :

dr.Nailla Fariq Alfiani

Pedoman klinis tindakan transcatheter aortic valve implantation (TAVI) yang perlu diperhatikan adalah pentingnya melakukan seleksi pasien melalui penilaian multidisiplin, evaluasi anatomi katup dan akses vaskular dengan pencitraan multimodal, serta pemilihan jenis dan ukuran katup yang akurat. Secara umum, akses transfemoral merupakan yang direkomendasikan. Setelah tindakan, pemantauan dilakukan berkelanjutan.[3,6,9-11]

Seleksi Pasien Multidisiplin

Indikasi TAVI ditentukan melalui diskusi multidisiplin oleh Heart Team yang melibatkan spesialis kardiologi intervensi, spesialis bedah toraks dan kardiovaskular, spesialis pencitraan kardiovaskular, dan spesialis anestesiologi. Keputusan tindakan mempertimbangkan risiko pembedahan, komorbiditas, harapan hidup, serta preferensi pasien dan keluarga.[2,6,7,11]

Referensi

1. Ciardetti, N.; Ciatti, F.; Nardi, G.; Di Muro, F.M.; et al. Advancements in Transcatheter Aortic Valve Implantation: A Focused Update. Medicina 2021, 57, 711. https://doi.org/10.3390/medicina57070711
2. Monteiro, J. P., Brugaletta, S., Freixa, X., Regueiro, A., Rijo, D., & Sabaté, M. The roadmap to transcatheter aortic valve implantation. Revista Portuguesa de Cardiologia, 42(9), 733–739. (2023). https://doi.org/10.1016/j.repc.2022.09.004
3. Postolache, A., Sperlongano, S., & Lancellotti, P. TAVI after More Than 20 Years. Journal of clinical medicine, 12(17), 5645. (2023). https://doi.org/10.3390/jcm12175645
4. Webb, J. G., Blanke, P., Akodad, M., et al. TAVI in 2022: remaining issues and future direction. Archives of Cardiovascular Diseases, 115 (4), 235–242. (2022). https://doi.org/10.1016/j.acvd.2022.04.001
5. Rahman, F., & Resar, J. R. TAVI Beyond 3 Years: Durability and Predictors for Survival. Innovations (Philadelphia, Pa.), 16(5), 417–425. (2021). https://doi.org/10.1177/15569845211017558
6. Otto, C. M., et al. 2022 ACC/AHA guideline for the management of patients with valvular heart disease. Nature Reviews Cardiology, 19, 587–589. (2022). https://doi.org/10.1038/s41569-022-00734-5
9. Reardon, M. J., et al. Clinical outcomes and patient selection for transcatheter aortic valve implantation. Journal of the American Heart Association, 12, e033768. (2023). https://doi.org/10.1161/JAHA.123.033768
10. Mangieri, A., et al. Expanding indications of transcatheter aortic valve implantation: Current evidence and future directions. Journal of Clinical Medicine, 12, 6123. (2023). https://doi.org/10.3390/jcm13206123
11. Vahanian, A., Beyersdorf, F., Praz, F., Milojevic, M., Baldus, S., Bauersachs, J.et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. European Heart Journal, 43(7), 561–632. (2022). https://doi.org/10.1093/eurheartj/ehab395
12. Varghese, J. J., & Maniar, H. S. Transcatheter aortic valve replacement. In StatPearls. Treasure Island (FL): StatPearls Publishing. (2024). https://www.ncbi.nlm.nih.gov/books/NBK537273/
15. Nechwatal, R. M., Bestehorn, K., Leuschner, F., Hagendorff, A., Guha, M., & Schlitt, A. Nachsorge nach kathetergestütztem perkutanen Aortenklappenersatz (TAVI) [Postacute care after transcatheter aortic valve implantation (TAVI)]. Herz, 46(Suppl 1), 41–47. (2021). https://doi.org/10.1007/s00059-020-04915-1
18. Harloff, M. T., Percy, E. D., Hirji, S. A., Yazdchi, F., Shim, H., Chowdhury, M., Malarczyk, A. A., Sobieszczyk, P. S., Sabe, A. A., Shah, P. B., & Kaneko, T. A step-by-step guide to trans-axillary transcatheter aortic valve replacement. Annals of cardiothoracic surgery, 9(6), 510–521. (2020). https://doi.org/10.21037/acs-2020-av-79
19. Van Praet, K. M., Nersesian, G., & Kukucka, M. Standard Transfemoral Transcatheter Aortic Valve Replacement (Case Report No. 1754). Multimedia Manual of Cardiothoracic Surgery. Oxford University Press. (2022). https://mmcts.org/case-report/1754
20. Nejjari, M., Darmon, A., & Digne, F. Comment éviter et gérer une complication vasculaire pendant la procédure de TAVI [How to avoid and manage a vascular complication during TAVI procedure]. Annales de cardiologie et d'angeiologie, 73(4), 101780. (2024). https://doi.org/10.1016/j.ancard.2024.101780
21. Khadija, H. A., Alnees, M., Gandelman, G., George, J., & Blatt, A. TAVI complication: Prosthetic valve leaflet dislodgment after post-dilatation. International journal of surgery case reports, 124, 110441. (2024). https://doi.org/10.1016/j.ijscr.2024.110441

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