Aortic valvular disease in adults. A potentially lethal clinical problem

Area of Science:

• Cardiology
• Cardiac Surgery

Background:

• Asymptomatic aortic valvular disease, including aortic stenosis and regurgitation, necessitates careful follow-up due to potential life-threatening complications.
• Normal systolic ventricular function in these patients does not negate the inherent risks associated with the condition.

Purpose of the Study:

• To outline the management strategies for patients with asymptomatic and symptomatic aortic valvular disease.
• To emphasize the importance of timely intervention, particularly aortic valve replacement, in preventing adverse outcomes.
• To discuss the considerations in choosing between mechanical and bioprosthetic valves for aortic valve replacement.

Main Methods:

• Review of current clinical guidelines and literature on aortic valvular disease management.
• Analysis of indications for medical therapy versus surgical intervention.
• Evaluation of factors influencing prosthetic valve selection.

Main Results:

• Medical therapy can aid long-term management of chronic aortic regurgitation, but valve replacement is indicated before heart failure or significant left ventricular dilatation.
• Aortic valve replacement is strongly recommended for symptomatic, severe aortic stenosis due to the high risk of sudden death.
• Prosthetic valve choice involves mechanical, bioprosthetic, allograft, and autograft options, with future trends leaning towards wider use of the latter two.

Conclusions:

• Careful follow-up and timely intervention are critical for patients with asymptomatic aortic valvular disease.
• Aortic valve replacement is a life-saving procedure for severe symptomatic aortic stenosis and advanced aortic regurgitation.
• The selection of an appropriate prosthetic valve is a key decision in the surgical management of aortic valvular disease.