quarta-feira, dezembro 03, 2008
COARCTAÇÃO DA AORTA
Recommendations for Interventional and Surgical Treatment of Coarctation of the Aorta in Adults
1. Intervention for coarctation is recommended in the following circumstances:
a. Peak-to-peak coarctation gradient greater than or equal to 20 mm Hg. (Level of Evidence: C)
b. Peak-to-peak coarctation gradient less than 20 mm Hg in the presence of anatomic imaging evidence of significant coarctation with radiological evidence of significant collateral flow. (Level of Evidence: C)
2. Choice of percutaneous catheter intervention versus surgical repair of native discrete coarctation should be determined by consultation with a team of ACHD cardiologists, interventionalists, and surgeons at an ACHD center. (Level of Evidence: C)
3. Percutaneous catheter intervention is indicated for recurrent, discrete coarctation and a peak-to-peak gradient of at least 20 mm Hg. (Level of Evidence: B)
4. Surgeons with training and expertise in CHD should perform operations for previously repaired coarctation and the following indications:
a. Long recoarctation segment. (Level of Evidence: B)
b. Concomitant hypoplasia of the aortic arch. (Level of Evidence: B)
ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Adults With Congenital Heart Disease)
. A partir de 20 mmhg na coarctação já seria indicativo de intervenção, pela diretriz fresquinha.
Ao Ecocardiograma, devo crer.
Usando a equação de Bernolli simplificada ou com a inclusão da Velocidade pré estenose...