Document Detail


Management of asymptomatic severe aortic stenosis.
MedLine Citation:
PMID:  18929238     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with symptomatic severe aortic stenosis (AS) benefit from aortic valve replacement (AVR). Management of severe AS in the absence of symptoms is, however, controversial and often challenging. Unselected premature AVR carries the risks of cardiac surgery; delayed AVR due to unrecognized symptoms can result in a dismal outcome. Echocardiography is the standard tool to evaluate and follow patients with AS. Nevertheless, most of the current echocardiographic parameters have limitations in predicting symptom onset and clinical outcome. The same applies to clinical parameters, exercise stress testing, and other imaging modalities used in AS evaluation and serial follow-up. Predictors of outcome could, however, help to identify asymptomatic patients who would benefit from expedited AVR with the goal to reduce mortality. This review will discuss the most relevant clinical studies and guidelines on management of asymptomatic severe AS, with an emphasis on providing concise information for identifying patients at high risk.
Authors:
Jacob P Dal-Bianco; Bjoy K Khandheria; Farouk Mookadam; Federico Gentile; Partho P Sengupta
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  52     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-20     Completed Date:  2008-11-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1279-92     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon / methods*,  mortality
Aortic Valve Stenosis / diagnosis*,  mortality,  therapy*
Echocardiography, Doppler
Electrocardiography
Exercise Test
Female
Heart Valve Prosthesis Implantation / methods*,  mortality
Humans
Magnetic Resonance Imaging
Male
Postoperative Complications / diagnosis,  mortality
Predictive Value of Tests
Prognosis
Randomized Controlled Trials as Topic
Risk Assessment
Severity of Illness Index
Stroke Volume
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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