Substituição da Válvula Aórtica: Opções de Procedimento, Tipos de Válvula e Recuperação

Aortic valve replacement (AVR) treats stenosis or regurgitation via open surgery or transcatheter (TAVR) approaches. Valve choice depends on age, lifestyle, comorbidities, and patient preference.

Valve Types

• Mechanical (bileaflet pyrolytic carbon): Lifetime durability; requires lifelong warfarin (INR 2.0–3.0); audible click.
• Bioprosthetic (porcine/bovine pericardium): No long-term anticoagulation (aspirin only); limited durability (10–20 years); preferred for patients >65–70.
• Ross procedure: Autologous pulmonary valve moved to aortic position; pulmonary homograft replaces pulmonary valve. Growth potential in children; avoids anticoagulation; technically complex.
• TAVR: Bioprosthetic valve via femoral access; standard for high/intermediate surgical risk; expanding to low-risk patients.

Post-Operative Care

• ICU monitoring, early mobilization.
• Anticoagulation per valve type.
• Endocarditis prophylaxis for dental procedures.
• Lifelong cardiology follow-up (echocardiography, INR if mechanical).

Shared decision-making incorporates age, lifestyle, comorbidities, and patient values.