[Asymptomatic aortic stenosis. When to operate, when to follow?]

(Asymptomatische Aortenstenose. Wann soll man operieren? Wann kann man zuwarten?)

Full Abstract

While there is generell agreement that patients with aortic stenosis (AS) who have already developed symptoms, such as exertional dyspnea, angina or dizziness and syncope, require urgent surgery because of their otherwise very poor outcome, the management of asymptomatic severe AS remains controversial. Although prevention of sudden death, prevention of irreversible myocardial damage, lower operative risk and a possible short duration of the asymptomatic phase of the disease have been proposed as arguments for early elective surgery, currently available data do not support that the risk of surgery and prosthesis-related long-term complications can generally be outweighed by a potential benefit. Thus, surgery cannot be recommended for all asymptomatic patients. Since patients often do not report their symptoms immediately and waiting lists for surgery exist in some countries, risk stratification with selection of those patients who are likely to develop symptoms and require surgery within a short time period seems to be the ideal approach. The most important predictors of outcome are the degree of valvular calcification, the hemodynamic progression rate, the development of symptoms during exercise testing, and plasma levels of cardiac neurohomones.

Author information

Author/s: Baumgartner, Helmut (H);

Affiliation: Abteilung für Kardiologie, Medizinische Universität Wien, Wien, Osterreich. helmut.baumgartner(-atsign-)meduniwien.ac.at

Journal and publication information

Publication Type: English Abstract; Journal Article

Journal: Herz (Herz), published in Germany. (Language: ger)

Reference: 2006-Oct; vol 31 (issue 7) : pp 664-9

Dates: Created 2006/10/30; Completed 2007/05/10; Revised 2007/11/15;

PMID: 17072780, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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