Challenges in the management of severe asymptomatic aortic stenosis
2011 (English)In: European Journal of Cardio-Thoracic Surgery, ISSN 1010-7940, E-ISSN 1873-734X, Vol. 40, no 4, 848-850 p.Article in journal (Refereed) Published
It is well established that the treatment of symptomatic aortic stenosis is timely aortic valve replacement. By contrast, the optimum treatment of severe asymptomatic aortic stenosis is not clear. There are no randomised controlled trials on which to base management. Current guidelines recommend a watch-and-see approach, with surgery deferred until symptoms develop, unless certain criteria, for example, severe left-ventricular hypertrophy or an abnormal exercise test, are met. This strategy is based on the observation that asymptomatic patients have a low risk of sudden death. It ignores, however, the long-term consequences of irreversible left-ventricular remodelling resulting from a high afterload, which could potentially adversely affect perioperative and long-term outcomes. Observational studies suggest that early aortic valve replacement provides long-term outcomes superior to deferred surgery. We suggest that clinicians should consider this approach when planning how best to manage patients with severe asymptomatic aortic stenosis.
Place, publisher, year, edition, pages
Berlin: Springer , 2011. Vol. 40, no 4, 848-850 p.
Aortic stenosis, Aortic valve replacement, Valve disease
Cardiac and Cardiovascular Systems
IdentifiersURN: urn:nbn:se:umu:diva-45909DOI: 10.1016/j.ejcts.2011.01.031PubMedID: 21367614OAI: oai:DiVA.org:umu-45909DiVA: diva2:435708
Available online 1 March 2011.2011-08-192011-08-192014-12-04Bibliographically approved