Manes Maria Teresa, Ritacco Anna Rita, Cassano Susanna, Ferrò Maria Teresa, Manduca Bruno, Spaccarotella Carmen, Musacchio Domenico
Department of Cardiology, Paola-Cetraro Hospital, Paola CS, Italy.
Department of Hemodynamics, University Magna Grecia, Catanzaro CZ, Italy.
J Cardiovasc Echogr. 2024 Apr-Jun;34(2):77-81. doi: 10.4103/jcecho.jcecho_12_23. Epub 2024 Jun 28.
The pandemic changed the type of patients. The concept of "patient at the center" became concrete. The execution of simple consultancy was overcome to create effective collaboration and fruitful exchanges between specialists. The "Heart Team" model is on increasing affirmation. The TEAM-BASED approach in the cardiology field is successfully used in patients suffering from ischemic heart disease and valvulopathies for the choice of possible treatments. Degenerative type Sao is the most frequent valvulopathy among the valvulopathies in Western countries and its incidence is correlated with age. In high-risk patients, percutaneous valve replacement (transcatheter aortic valve implantation) is the most valid therapeutic option. The implantation of biological prostheses raises the problem of both degeneration and dysfunction of the prosthesis itself over time in subjects of advanced age and with comorbidities. In this scenario, valve-in-valve (VinV) is a valid therapeutic alternative in high-risk patients. A clinical case of aortic prosthetic degeneration, as an outcome of endocarditis, treated with VinV is presented. The therapeutic decision was made by an "Electronic Heart Team" which represents a further evolution of the treatment pathways and reduces the distance between the specialists in "Hub" Centers and the "Spoke" center.
疫情改变了患者类型。“以患者为中心”的理念变得具体起来。克服了简单咨询的做法，以在专家之间建立有效的合作和富有成效的交流。“心脏团队”模式越来越得到认可。心脏病领域基于团队的方法已成功应用于患有缺血性心脏病和瓣膜病的患者，以选择可能的治疗方案。退行性瓣膜病是西方国家瓣膜病中最常见的类型，其发病率与年龄相关。在高危患者中，经皮瓣膜置换术（经导管主动脉瓣植入术）是最有效的治疗选择。生物假体的植入随着时间的推移在老年和患有合并症的患者中引发了假体本身退化和功能障碍的问题。在这种情况下，瓣中瓣（VinV）是高危患者的一种有效治疗选择。本文介绍了一例因心内膜炎导致主动脉假体退化并采用VinV治疗的临床病例。治疗决策由一个“电子心脏团队”做出，该团队代表了治疗途径的进一步发展，并缩短了“枢纽”中心和“辐条”中心的专家之间的距离。
