Aortic Valve Stenosis: Progress from Diagnosis to Treatment

Area of Science:

• Cardiology
• Valvular Heart Disease
• Geriatric Medicine

Background:

• Aortic stenosis (AS) is the most common valvular heart disease in Western countries, primarily affecting older individuals.
• AS progresses to ventricular hypertrophy, impaired cardiac function, and symptomatic decline, influenced by comorbidities and myocardial damage.
• Current diagnosis relies on echocardiography, but discordant grading often necessitates advanced imaging for accurate risk stratification.

Purpose of the Study:

• To provide a comprehensive overview of aortic stenosis diagnosis, risk stratification, and management.
• To highlight the role of multimodality imaging in clarifying AS severity and guiding treatment decisions.
• To discuss challenges and individualized approaches for complex AS cases, including those with cardiogenic shock or cardiac amyloidosis.

Main Methods:

• Review of current diagnostic modalities, emphasizing transthoracic echocardiography and advanced imaging techniques.
• Analysis of risk stratification strategies for patients with aortic stenosis.
• Examination of interventional treatment options, including surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR).

Main Results:

• Echocardiography is the primary diagnostic tool, but advanced imaging is crucial for resolving grading discrepancies.
• No medical therapy can halt AS progression, making interventional treatment essential.
• SAVR and TAVR represent the main therapeutic interventions for aortic stenosis.

Conclusions:

• Optimal management of aortic stenosis integrates multimodality imaging, precise risk stratification, and tailored interventional strategies.
• Individualized, multidisciplinary care is vital for complex clinical scenarios.
• Contemporary approaches aim to optimize patient outcomes in aortic stenosis management.