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Marqueurs pronostiques biologiques et morphologiques du TAVI à l’ère de l’évolution des pratiques

Abstract : Management of aortic stenosis was revolutionized by the advent of transcatheter aortic valve replacement (TAVI). This technique, initially targeting patients at high surgical risk, was extended to lower risk patients regarding to improved outcomes and was accompanied, over the years, by a simplification at each step of the procedure. However, the careful selection of patients upstream of the procedure remains the key to success. Clinical and echographic factors are not sufficient to allow an accurate assessment of their risk profile. Thus, biomarkers and aortic valve calcifications evaluation may improve risk profile stratification. The objective of this thesis was to evaluate the prognostic value of troponin and aortic valve calcium score in patients undergoing TAVI in the era of TAVI simplificationThe first chapter of this thesis confirmed the prognostic value of pre- and post-procedure troponin (myocardial injury) in patients undergoing TAVI and of calcium score with previous generation prosthesis.The second chapter highlighted the impact of predilatation on this post-procedure troponin elevation with a potential prognostic impact.
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Mariama Akodad. Marqueurs pronostiques biologiques et morphologiques du TAVI à l’ère de l’évolution des pratiques. Cardiologie et système cardiovasculaire. Université Montpellier, 2019. Français. ⟨NNT : 2019MONTT061⟩. ⟨tel-02611125⟩

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