{"id":2126,"date":"2026-06-08T00:00:00","date_gmt":"2026-06-08T03:00:00","guid":{"rendered":"https:\/\/sevenresiduosaude.com.br\/blog\/?p=2126"},"modified":"2026-06-08T00:00:00","modified_gmt":"2026-06-08T03:00:00","slug":"rss-cirurgia-cardio-adulto-crm-revascularizacao-avr-mvr-tavi-mitraclip-valvar-endovascular","status":"publish","type":"post","link":"https:\/\/sevenresiduosaude.com.br\/blog\/rss-cirurgia-cardio-adulto-crm-revascularizacao-avr-mvr-tavi-mitraclip-valvar-endovascular\/","title":{"rendered":"RSS cardio adulto: CRM, AVR, MVR, TAVI"},"content":{"rendered":"

A regula\u00e7\u00e3o brasileira de RSS \u00e9 frequentemente desafiada por gestores de centros de cir cardio adulto. Em 2026, h\u00e1 uma demanda crescente de hospitais com unidade cardio adulto \u2014 CRM revasculariza\u00e7\u00e3o mioc\u00e1rdica<\/strong> com bypass de safena + AMI art\u00e9ria mam\u00e1ria interna LIMA-LAD ou bilateral BIMA + radial artery RA + GEA gastroepipl\u00f3ica para coronariopatia multivasos, AVR aortic valve replacement<\/strong> com biopr\u00f3tese Carpentier-Edwards Magna Ease + Sorin Mitroflow + Medtronic Hancock + St. Jude Trifecta R$ 18-45k biopr\u00f3tese + mec\u00e2nica On-X + St. Jude Regent R$ 8-18k mec\u00e2nica, MVR mitral valve replacement<\/strong> + reparo mitral com Carpentier-Edwards Physio Ring + Edwards Cosgrove + St. Jude Tailor + Medtronic CG Future R$ 18-35k anel + corda artificial Gore-Tex CV-5, TAVI Transcatheter Aortic Valve Implantation<\/strong> Edwards SAPIEN 3 Ultra + Medtronic CoreValve Evolut + Boston Acurate Neo R$ 80-180k para estenose a\u00f3rtica severa em alto risco cir\u00fargico, MitraClip transcatheter mitral repair<\/strong> Abbott + Pascal Edwards + Cardioband Edwards anuloplastia + Tendyne Abbott TMVR R$ 80-150k, TriClip tricuspide<\/strong> Abbott + Cardioband Edwards + EVOQUE Edwards, Watchman LAA closure<\/strong> Boston Scientific R$ 25-45k para fibrila\u00e7\u00e3o atrial n\u00e3o-anticoagul\u00e1vel, CABG off-pump beating heart<\/strong> + minimally invasive direct coronary artery bypass MIDCAB + robotic CABG Da Vinci, TX card\u00edaco<\/strong> doador falecido + bypass + m\u00e1quina perfus\u00e3o OCS Heart Transmedics. A consequ\u00eancia \u00e9 a urg\u00eancia de PGRSS dedicado para cardio adulto<\/strong> \u2014 captura de CEC circula\u00e7\u00e3o extracorp\u00f3rea<\/strong> Maquet HL 30 \/ Sorin C5 \/ Stockert S5 + oxigenador Quadrox-iD adulto Maquet R$ 4-8k descart\u00e1vel + reservat\u00f3rio venoso 2L + cardioplegia Custodiol HTK \/ Buckberg sangue-cristaloide \/ del Nido Plegisol, biopr\u00f3tese AVR\/MVR<\/strong> Carpentier-Edwards Magna Ease\/Physio Ring + St. Jude Trifecta\/Tailor + Medtronic Hancock\/CG Future R$ 18-45k + livro RBI 10y, TAVI\/MitraClip\/TriClip\/Watchman<\/strong> Edwards SAPIEN 3 Ultra\/Medtronic Evolut\/Boston Acurate Neo\/Abbott MitraClip R$ 25-180k descart\u00e1vel + livro RBI tecnovigil\u00e2ncia obrigat\u00f3ria, pr\u00f3tese vascular<\/strong> PTFE Gore-Tex 6-8mm + Dacron Vascutek + Hemashield para reconstru\u00e7\u00e3o a\u00f3rtica, bal\u00e3o intra-a\u00f3rtico IABP<\/strong> Maquet\/Datascope\/Medtronic R$ 8-15k contrapulsa\u00e7\u00e3o ventricular + ECMO veno-arterial Quadrox-iD adulto R$ 25-50k, patch peric\u00e1rdico bovino CardioCel<\/strong> Admedus + Edwards bovine pericardium R$ 3-8k + clipe Hem-O-Lok L\/XL<\/strong> Teleflex + bisturi Harmonic ACE \/ LigaSure<\/strong>, monitor hemodin\u00e2mico<\/strong> PiCCO Pulsion + Swan-Ganz Edwards + linha arterial femoral\/radial + ScvO2. A realidade \u00e9 que cardio adulto produz RSS de alt\u00edssima complexidade. PGRSS de cardio adulto \u00e9 cadeia integrada<\/strong> \u2014 come\u00e7a no diagn\u00f3stico<\/strong> (eco TT\/TE + cateterismo + RM card\u00edaca + CT coron\u00e1ria), passa pela terapia<\/strong> (CRM + AVR + MVR + TAVI + MitraClip + TX) e termina no acompanhamento<\/strong> (eco trim + INR + dual antiplaquet\u00e1ria + estatina). O conjunto soma R$ 38.000-78.000\/m\u00eas<\/strong> que muitos gestores subestimam.<\/p>\n

Para o gestor que opera ou planeja unidade cardio adulto, \u00e9 fundamental considerar a complexidade desde o in\u00edcio.<\/p>\n

Os procedimentos cardio adulto e os RSS espec\u00edficos<\/h2>\n

Em uma opera\u00e7\u00e3o de qualquer porte, a cadeia gera RSS espec\u00edficos.<\/p>\n\n\n\n\n\n\n\n\n\n
Procedimento<\/th>\nImplante<\/th>\nCEC<\/th>\nRisco RSS<\/th>\n<\/tr>\n<\/thead>\n
CRM 3-5 enxertos<\/td>\nLIMA+RIMA+RA+saphena<\/td>\nCEC adulto + cardioplegia<\/td>\nA4 + RBI tecnovig<\/td>\n<\/tr>\n
AVR biopr\u00f3tese<\/td>\nCarpentier-Edwards\/Magna R$ 18-45k<\/td>\nCEC + cardioplegia<\/td>\nA4 + RBI permanente<\/td>\n<\/tr>\n
MVR + reparo<\/td>\nAnel Physio + corda artificial<\/td>\nCEC + cardioplegia<\/td>\nA4 + RBI permanente<\/td>\n<\/tr>\n
TAVI Edwards\/Medtronic<\/td>\nSAPIEN 3\/Evolut R$ 80-180k<\/td>\nN\u00e3o-CEC (transcateter)<\/td>\nA4 + RBI tecnovig<\/td>\n<\/tr>\n
MitraClip Abbott<\/td>\nMitraClip R$ 80-150k<\/td>\nN\u00e3o-CEC (transcateter)<\/td>\nA4 + RBI tecnovig<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

A soma t\u00edpica \u00e9 entre R$ 38.000-78.000\/m\u00eas<\/strong> em PGRSS dedicado de cardio adulto vs R$ 14.000-28.000<\/strong> em PGRSS gen\u00e9rico subdimensionado.<\/p>\n

A CRM revasculariza\u00e7\u00e3o + CEC adulto: o procedimento de alt\u00edssimo padr\u00e3o<\/h2>\n

A primeira camada do desafio \u00e9 a CRM. Padr\u00e3o setorial inclui (a) acesso esternotomia mediana<\/strong> + LIMA art\u00e9ria mam\u00e1ria interna esquerda dissec\u00e7\u00e3o + RIMA bilateral opcional + radial artery + saphena reversa; (b) CEC adulto<\/strong> Maquet HL 30 \/ Sorin C5 \/ Stockert S5 com oxigenador Quadrox-iD adulto Maquet R$ 4-8k descart\u00e1vel + reservat\u00f3rio venoso + bomba; (c) cardioplegia<\/strong> Custodiol HTK Histidine-Tryptophan-Ketoglutarate \/ Buckberg sangue-cristaloide \/ del Nido Plegisol single-shot; (d) off-pump beating heart<\/strong> alternativa com Octopus stabilizer + Starfish positioner Medtronic; (e) livro RBI CRM + CEC<\/strong> com reten\u00e7\u00e3o 10 anos.<\/p>\n

Hospital com 200-600 CRMs\/ano \u00d7 R$ 8-12k consum\u00edveis CEC = R$ 1.6-7.2M\/ano em CRM + CEC + livro RBI. Como discutimos no post sobre PGRSS de cardiocir<\/a>, CEC \u00e9 estruturante.<\/p>\n

A AVR + MVR + reparo valvar: o est\u00e1gio biopr\u00f3teses<\/h2>\n

A segunda camada \u00e9 a valvar. Padr\u00e3o setorial inclui (a) AVR biopr\u00f3tese<\/strong> Carpentier-Edwards Magna Ease + Sorin Mitroflow + Medtronic Hancock II + St. Jude Trifecta R$ 18-45k peric\u00e1rdio bovino\/equino; (b) AVR mec\u00e2nica<\/strong> On-X Cryolife + St. Jude Regent + Medtronic Open-Pivot R$ 8-18k pirol\u00edtico; (c) MVR + reparo mitral<\/strong> com anel Carpentier-Edwards Physio Ring + Edwards Cosgrove + St. Jude Tailor + Medtronic CG Future R$ 18-35k + corda artificial Gore-Tex CV-5 + neochordae; (d) double valve replacement DVR<\/strong> AVR+MVR + tricuspide replacement TVR + ASD\/VSD closure; (e) livro RBI valvar<\/strong> com reten\u00e7\u00e3o 10 anos + tecnovigil\u00e2ncia obrigat\u00f3ria.<\/p>\n

Hospital com 100-300 AVRs + 50-150 MVRs\/ano \u00d7 R$ 25k m\u00e9dio = R$ 3.75-11.25M\/ano em valvar + livro RBI.<\/p>\n

O TAVI + MitraClip + TX card\u00edaco: o est\u00e1gio de alt\u00edssima inova\u00e7\u00e3o<\/h2>\n

A terceira camada \u00e9 a inova\u00e7\u00e3o. Padr\u00e3o setorial inclui (a) TAVI Edwards SAPIEN 3 Ultra<\/strong> transfemoral\/transapical\/transaxillar\/transcaval + Medtronic CoreValve Evolut R\/PRO<\/strong> + Boston Acurate Neo<\/strong> R$ 80-180k; (b) MitraClip Abbott<\/strong> transcateter + Pascal Edwards<\/strong> + Cardioband Edwards<\/strong> anuloplastia + Tendyne Abbott TMVR<\/strong> transcatheter MV replacement R$ 80-150k; (c) TriClip Abbott<\/strong> + Cardioband + EVOQUE Edwards tricuspide; (d) Watchman LAA Boston Scientific<\/strong> R$ 25-45k para FA n\u00e3o-anticoagul\u00e1vel; (e) TX card\u00edaco<\/strong> doador falecido + OCS Heart Transmedics normot\u00e9rmica R$ 100-150k + tacrolimus+micofenolato+prednisona Lista C5.<\/p>\n

Hospital com 50-150 TAVIs + 30-100 MitraClips + 5-20 TXs\/ano \u00d7 R$ 100-180k = R$ 8.5-49M\/ano em inova\u00e7\u00e3o card\u00edaca + livro RBI tecnovigil\u00e2ncia.<\/p>\n

Tr\u00eas perfis de PGRSS para cardio adulto<\/h2>\n

PGRSS gen\u00e9rico subdimensionado.<\/strong> Sem cobertura espec\u00edfica para CEC + valvar + TAVI + Lista C5. Custo mensal R$ 14.000-28.000<\/strong>, efic\u00e1cia limitada.<\/p>\n

PGRSS dedicado intermedi\u00e1rio.<\/strong> Cobertura para CRM + AVR\/MVR, sem TAVI + MitraClip + TX. Custo mensal R$ 28.000-52.000<\/strong>, efic\u00e1cia 100-200%.<\/p>\n

PGRSS dedicado completo cardio adulto.<\/strong> CRM + AVR + MVR + TAVI + MitraClip + TriClip + Watchman + TX + integra\u00e7\u00e3o com PGRSS de cardio pedi\u00e1trica<\/a>. Custo mensal R$ 52.000-78.000<\/strong>, ROI 250-500%.<\/p>\n

Os tr\u00eas erros que aparecem em PGRSS cardio adulto subdimensionado<\/h2>\n

O primeiro \u00e9 o subdimensionamento de CEC adulto<\/strong>. Quadrox-iD R$ 4-8k circuito \u00d7 200-600 CRMs\/ano + livro RBI obrigat\u00f3rio.<\/p>\n

O segundo \u00e9 a aus\u00eancia de RBI valvar Carpentier+St. Jude+Medtronic<\/strong>. Biopr\u00f3tese R$ 18-45k \u00e9 tecnovigil\u00e2ncia + reten\u00e7\u00e3o 10y.<\/p>\n

O terceiro \u00e9 a descarte de TAVI\/MitraClip\/Watchman como Grupo D<\/strong>. Edwards SAPIEN+Medtronic Evolut+Abbott MitraClip+Watchman R$ 25-180k s\u00e3o tecnovigil\u00e2ncia obrigat\u00f3ria.<\/p>\n

A regula\u00e7\u00e3o de PGRSS no Brasil est\u00e1 em fase de moderniza\u00e7\u00e3o t\u00e9cnica acelerada com cardio adulto como prioridade. As institui\u00e7\u00f5es que estruturam PGRSS dedicado desde o in\u00edcio \u2014 alinhadas com calend\u00e1rio 2026 de compliance<\/a> \u2014 atravessam o crescimento sem solavanco. Para gestores que precisam alinhar com gest\u00e3o paralela industrial, o portal Seven Res\u00edduos sobre servi\u00e7os completos<\/a> traz a perspectiva integrada. A SBCCV Sociedade Brasileira de Cirurgia Cardiovascular<\/a> \u00e9 refer\u00eancia t\u00e9cnica.<\/p>\n

Solicite cota\u00e7\u00e3o PGRSS de cardio adulto<\/a><\/strong> \u2014 cap\u00edtulo dedicado a CRM + CEC adulto Maquet HL 30\/Sorin C5\/Stockert S5 + Quadrox-iD adulto, AVR\/MVR Carpentier-Edwards Magna\/St. Jude Trifecta\/Medtronic Hancock, TAVI Edwards SAPIEN 3 Ultra + Medtronic CoreValve Evolut, MitraClip Abbott + Pascal Edwards + Cardioband, TX card\u00edaco + OCS Heart Transmedics.<\/p>\n","protected":false},"excerpt":{"rendered":"

Cir cardio adulto gera RSS espec\u00edfico \u2014 CRM, AVR, MVR, TAVI, MitraClip. PGRSS dedicado.<\/p>\n","protected":false},"author":3,"featured_media":2125,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[2944,1028,2678,2555],"class_list":["post-2126","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-compliance-legislacao","tag-cardio-adulto","tag-crm","tag-mitraclip","tag-tavi"],"_links":{"self":[{"href":"https:\/\/sevenresiduosaude.com.br\/blog\/wp-json\/wp\/v2\/posts\/2126","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sevenresiduosaude.com.br\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sevenresiduosaude.com.br\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sevenresiduosaude.com.br\/blog\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/sevenresiduosaude.com.br\/blog\/wp-json\/wp\/v2\/comments?post=2126"}],"version-history":[{"count":1,"href":"https:\/\/sevenresiduosaude.com.br\/blog\/wp-json\/wp\/v2\/posts\/2126\/revisions"}],"predecessor-version":[{"id":4288,"href":"https:\/\/sevenresiduosaude.com.br\/blog\/wp-json\/wp\/v2\/posts\/2126\/revisions\/4288"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/sevenresiduosaude.com.br\/blog\/wp-json\/wp\/v2\/media\/2125"}],"wp:attachment":[{"href":"https:\/\/sevenresiduosaude.com.br\/blog\/wp-json\/wp\/v2\/media?parent=2126"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sevenresiduosaude.com.br\/blog\/wp-json\/wp\/v2\/categories?post=2126"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sevenresiduosaude.com.br\/blog\/wp-json\/wp\/v2\/tags?post=2126"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}