TY - JOUR
T1 - Moderate aortic stenosis
T2 - Culprit or bystander?
AU - Pankayatselvan, Varayini
AU - Raber, Inbar
AU - Playford, David
AU - Stewart, Simon
AU - Strange, Geoff
AU - Strom, Jordan B.
N1 - Funding Information:
Funding JBS reports funding from the National Heart, Lung, and Blood Institute (1K23HL144907). SS reports funding from the National Health and Medical Research Council of Australia Senior Principal Research Fellowship (GNT1135894).
Publisher Copyright:
©
PY - 2022/1/24
Y1 - 2022/1/24
N2 - Non-rheumatic aortic stenosis (AS) is among the most common valvular diseases in the developed world. Current guidelines support aortic valve replacement (AVR) for severe symptomatic AS, which carries high morbidity and mortality when left untreated. In contrast, moderate AS has historically been thought to be a benign diagnosis for which the potential benefits of AVR are outweighed by the procedural risks. However, emerging data demonstrating the substantial mortality risk in untreated moderate AS and substantial improvements in periprocedural and perioperative mortality with AVR have challenged the traditional risk/benefit paradigm. As such, an appraisal of the contemporary data on morbidity and mortality associated with moderate AS and appropriate timing of valvular intervention in AS is warranted. In this review, we discuss the current understanding of moderate AS, including the epidemiology, current surveillance and management guidelines, clinical outcomes, and future studies.
AB - Non-rheumatic aortic stenosis (AS) is among the most common valvular diseases in the developed world. Current guidelines support aortic valve replacement (AVR) for severe symptomatic AS, which carries high morbidity and mortality when left untreated. In contrast, moderate AS has historically been thought to be a benign diagnosis for which the potential benefits of AVR are outweighed by the procedural risks. However, emerging data demonstrating the substantial mortality risk in untreated moderate AS and substantial improvements in periprocedural and perioperative mortality with AVR have challenged the traditional risk/benefit paradigm. As such, an appraisal of the contemporary data on morbidity and mortality associated with moderate AS and appropriate timing of valvular intervention in AS is warranted. In this review, we discuss the current understanding of moderate AS, including the epidemiology, current surveillance and management guidelines, clinical outcomes, and future studies.
KW - echocardiography
KW - epidemiology
KW - transcatheter aortic valve replacement
UR - http://www.scopus.com/inward/record.url?scp=85124106288&partnerID=8YFLogxK
UR - https://doi.org/10.25905/21825045.v1
U2 - 10.1136/openhrt-2021-001743
DO - 10.1136/openhrt-2021-001743
M3 - Article
AN - SCOPUS:85124106288
VL - 9
JO - Open Heart
JF - Open Heart
SN - 2053-3624
IS - 1
M1 - e001743
ER -