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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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Cardiac Damage Staging, Moderate Aortic Stenosis, and the Impact of Aortic Valve Replacement

Evan K Harmon1, Travis Howard1, Larisa G Tereshchenko2

  • 1Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.

JACC. Advances
|November 15, 2025
PubMed

Insights

Cardiac damage stage predicts outcomes in moderate aortic stenosis (AS). Damage progresses before aortic valve replacement (AVR) but improves after the procedure.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Clinical Outcomes

Background:

  • Cardiac damage staging is crucial for severe aortic stenosis (AS) outcomes.
  • Its role in moderate AS and the natural history pre- and post-aortic valve replacement (AVR) require further investigation.

Purpose of the Study:

  • To assess if cardiac damage stage predicts cardiovascular outcomes in moderate AS.
  • To describe the temporal changes in cardiac damage stage following AVR.

Main Methods:

  • Retrospective single-center cohort study of 688 patients with moderate AS.
  • Stratification by baseline cardiac damage stage.
  • Assessment of composite outcomes (all-cause death, HF hospitalization) and AVR timing.
  • Evaluation of cardiac damage stage changes over time.

Main Results:

  • Higher baseline cardiac damage stages correlated with increased risk of all-cause death and heart failure (HF) hospitalization.
  • Patients awaiting AVR experienced a progression of cardiac damage over a median of 3.1 years.
  • Cardiac damage showed partial recovery one year after AVR.

Conclusions:

  • Cardiac damage stage is a significant predictor of mortality and HF hospitalization in moderate AS.
  • Aortic valve replacement can lead to partial recovery of cardiac damage.
  • Understanding cardiac damage progression is vital for managing moderate AS patients.
Abstract

Keywords:
aortic valve replacementcardiac damagemoderate aortic stenosis

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