Data from a great Australian registry of nearly 250,000 people with a 5-year follow-up, presented at the European Society of Cardiology (ESC) Congress 2019 in Paris and simultaneously published in J Am Coll Cardiol, suggest that mortality due to severe aortic stenosis is similar to that due to moderate aortic stenosis. These data warn us...
Kidney Insufficiency and the Risk of Developing Aortic Stenosis in the Future
Chronic kidney disease, even in moderate or severe stages before dialysis, is associated with an increased risk of aortic stenosis according to this work recently published in J Am Coll Cardiol. Both share several risk factors, something that complicates the identification of the association between these diseases due to multiple confounding variables. The study...
Un Underestimated Symptom of Aortic Stenosis
For the first time, this long term observational study on a large cohort of contemporary patients with aortic stenosis (AS), has shown syncope is an underestimated threat, associated with worse prognosis after surgical aortic valve replacement (SAVR). It is interesting to note that other symptoms or early signs of AS that will normally indicate SAVR...
How long should we wait with asymptomatic aortic stenosis and preserved LVEF?
Courtesy of Dr. Carlos Fava. Asymptomatic severe aortic stenosis with preserved ventricular function is challenging. At present, it remains unclear whether we should operate or not and, according to some recent reports, neither do we know what patients will benefit from surgery. The study looked at 1678 patients with asymptomatic or minimally asymptomatic severe aortic...
Are Aortic Stenosis and Kidney Dysfunction Associated?
Courtesy of Dr. Carlos Fava. Aortic stenosis happens in 2.8% of patients over 75, and is even more frequent in dialysis patients. However, it remains unclear whether kidney dysfunction increases the risk of aortic stenosis. The present study looked at 1,121,875 patients from the SCREAM project (Stockholm CREAtinine Measurements). Mean age was 50, and...
Aortic Stenosis and Dialysis: Is TAVR the Strategy of Choice?
Courtesy of Dr. Carlos Fava. TAVR has been shown beneficial in high and moderate risk patients, but there is a group of patients that require dialysis on account of kidney deterioration. This comorbidity is due to bad cardiovascular evolution associated to diabetes, bleeding and thromboembolic events. For some time, we have been using an...
iFR Assessment of Intermediate Aortic Stenosis Lesions Consolidates
Once a big void that prevented us from effectively assessing functional compromise, intermediate aortic stenosis has made us treat many lesions “just in case”, to save us what would be a complicated procedure, had a valve been placed. Auspiciously, some light has been shed by several, most welcome, studies simultaneously published in J Am Coll...
What Should We Use for the Functional Assessment of Coronary Lesions in Severe Aortic Stenosis?
This systematic analysis measured intracoronary pressure in different phases of the cardiac cycle and flow velocity in patients with severe aortic stenosis and coronary artery disease, who were scheduled for transcatheter aortic valve replacement (TAVR). The aim was to determine the impact of aortic stenosis on: 1) flow, at different phases; 2) hyperemic coronary flow;...
Aortic Stenosis with Normal Flow Low Gradient: Should We Intervene or Wait?
Symptomatic patients with <1 cm² aortic valve area will benefit from an intervention regardless parameters such as flow and gradient, even if these are normal (or at least not severe). A valve replacement will be indicated without question (either surgical or percutaneous) in patients with >40 mHg mean gradient or low gradient justified by low...
SOLACI-SOCIME 2018 | Neonatal Aortic Stenosis Is a Surgical Disease… Really, in 2018?
Read articles on the main presentations of the first day of SOLACI-SOCIME 2018 Congress. See the presentation by Dr. Lee Benson, entitled “Neonatal Aortic Stenosis Is a Surgical Disease… Really, in 2018?”. We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.