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Unnecessary deaths from valvular aortic stenosis
M Olsson1, M Rosenqvist, G Forssell
1Department of Internal Medicine, Karolinska Hospital, Stockholm, Sweden.
Journal of Internal Medicine
|December 1, 1990
Summary
Many patients with aortic stenosis died without surgery, despite being eligible. Improved physician awareness of aortic valve replacement (AVR) curability could save lives.
Area of Science:
- Cardiology
- Public Health
- Medical Records Analysis
Background:
- Aortic stenosis is a significant cause of mortality.
- Surgical aortic valve replacement (AVR) is a viable treatment option.
Purpose of the Study:
- To determine the mortality rate of aortic stenosis patients eligible for AVR.
- To identify reasons for underutilization of AVR in suitable candidates.
Main Methods:
- Retrospective analysis of death records in Stockholm County.
- Comparison of deceased patients with those who underwent AVR.
- Review of medical records for surgical eligibility and diagnosis confirmation.
Main Results:
- 37 out of 70 deceased patients (53%) were identified as suitable AVR candidates.
- Only 16% of eligible deceased patients were considered for surgery by physicians.
- No significant clinical differences were found between deceased and operated patients, except for syncope.
Conclusions:
- A substantial number of eligible aortic stenosis patients did not receive timely surgical intervention.
- Insufficient physician knowledge regarding the curability of aortic stenosis likely contributed to under-treatment.
- Public health initiatives may be needed to improve AVR utilization.