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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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The current diagnosis and treatment of patients with aortic valve stenosis

Robert J Henning1

  • 1University of South Florida, Tampa, FL 33612, USA.

Future Cardiology
|March 17, 2021
PubMed

Insights

Aortic valve stenosis (AS) is a common heart condition. Severe AS, indicated by specific measurements, requires timely intervention, with valve replacement or transcatheter aortic valve implantation as key treatments.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Valvular Heart Disease

Background:

  • Aortic valve stenosis (AS) is a prevalent cardiovascular disease, often caused by bicuspid aortic valves or calcific degeneration.
  • Symptomatic severe AS significantly increases mortality risk, escalating from 1% annually to 2% monthly.

Purpose of the Study:

  • To discuss the staging and management strategies for aortic valve stenosis.
  • To review current treatment options, including surgical valve replacement and transcatheter aortic valve implantation.

Main Methods:

  • Diagnosis of severe AS based on echocardiographic parameters (valve area, velocity, gradient) and CT calcium scores.
  • Assessment of surgical risk using EuroSCORE and STS Predicted Risk of Mortality.
  • Evaluation of transcatheter aortic valve implantation (TAVI) as an alternative treatment.

Main Results:

  • Severe AS is defined by specific echocardiographic and CT criteria.
  • High surgical risk (EuroSCORE ≥20%, STS ≥8%) and comorbidities influence treatment decisions.
  • TAVI offers an alternative for patients across all surgical risk categories.

Conclusions:

  • Management of AS involves careful consideration of patient risk, valve characteristics, and patient preference.
  • Surgical valve replacement is recommended for low-to-intermediate risk patients.
  • TAVI is a viable option for older patients or those at high/prohibitive surgical risk.

Keywords:
EuroScoreSociety Thoracic Surgery Prediction of Mortality ScoreTAVI trialsaortic mean pressure gradientaortic stenosis managementaortic stenosis signsaortic stenosis symptomsaortic valve areaaortic valve calcium scorebicuspid aortic valvebioprosthetic aortic tissue valvescalcific aortic valve degenerationechocardiographic transaortic flow velocitymechanical aortic valvesrheumatic aortic stenosissurgical aortic valve replacement (SAVR)transthoracic aortic valve implantationt (TAVI)

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