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. 2009 Jan;5(1):29-35.
doi: 10.2174/157340309787048103.

Management of asymptomatic severe aortic stenosis

Robert L Stewart  1 , Kwan L Chan
Affiliations

Management of asymptomatic severe aortic stenosis

Robert L Stewart et al. Curr Cardiol Rev. 2009 Jan.

Abstract

Patients with symptomatic severe aortic stenosis (AS) benefit from aortic valve replacement surgery, but the management of patients with asymptomatic severe AS is more controversial. While cholesterol and angiotensin have been linked to AS progression, we should await the results of ongoing randomized trials before medical therapy to lower cholesterol or inhibit angiotensin can be recommended to limit disease progression. Clinical factors, echocardiographic parameters, valve morphology, exercise stress testing results, and cardiac biomarkers may be useful in identifying patients who will have early development of symptoms during follow-up and require closer monitoring. The risks associated with aortic valve replacement outweigh the benefits in the majority of patients with asymptomatic severe AS.

Keywords: Aortic valve stenosis; brain natriuretic peptide.; exercise testing; management; surgery; symptoms.

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Figures

Fig. (1)
Fig. (1)
Progression of AS in patients treated with intensive atorvastatin therapy on matched placebo. [from reference 22 with permission].
Fig. (2)
Fig. (2)
Event-free survival among patients with nor or mild aortic valve calcification compared with moderate or severe calcification. [from reference 5 with permission].
See this image and copyright information in PMC

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