Advances in the Diagnosis, Treatment, and Prognosis of Aortic Stenosis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 31 January 2025 | Viewed by 1382

Special Issue Editor


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Guest Editor
Division of Cardiac Surgery, Yale School of Medicine, New Haven, CT, USA
Interests: aortic valve; aortic disease

Special Issue Information

Dear Colleagues,

Aortic stenosis was first described in 1663 by Lazare Riviere with “ossified” aortic stenosis further delineated by Jean Nicolas Corvisart in the late 18th century.

Aortic stenosis is the most common valvular heart disease diagnosed in Western countries.  Patients with a tri-leaflet aortic valve present with calcific aortic stenosis in an older patient population with multiple co-morbidities; however, bicuspid aortic valve disease causes aortic stenosis in a younger population, in which long-term outcomes are especially relevant. Untreated aortic stenosis can progress to heart failure, and subsequent mortality can be high. Unlike other causes of heart failure, no effective medical therapy to prevent or abate aortic stenosis has been identified since it was first described in 1663. As such, aortic valve replacement is the only therapeutic option to impact both the survival and quality of life of these patients. Therefore, it is imperative to identify accurate and innovative methodologies to understand the genetic and acquired etiologies of aortic stenosis. In light of the continually aging population, it is equally as imperative to delineate effective diagnostic and therapeutic strategies to optimize outcomes in all age and economic subpopulations. Models of risk stratification permit timely therapeutic options for both moderate and severe aortic stenosis. This includes clearly defined indications for surgical and transcatheter aortic valve replacement.

The goal of this Special Issue is to highlight novel and innovative approaches to the diagnosis and risk stratification of aortic stenosis to optimize therapeutic strategies including surgical aortic valve replacement (SAVR) and transfemoral aortic valve replacement (TAVR).

Dr. Rita Milewski
Guest Editor

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Keywords

  • aortic valve stenosis
  • aortic valve replacement
  • surgical aortic valve replacement
  • transfemoral aortic valve replacement
  • risk stratification for aortic stenosis

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Published Papers (1 paper)

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18 pages, 4604 KiB  
Systematic Review
Sutureless Aortic Valve Replacement with Perceval Bioprosthesis Superior to Transcatheter Aortic Valve Implantation: A Promising Option for the Gray-Zone of Aortic Valve Replacement Procedures—A State-of-the-Art Systematic Review, Meta-Analysis, and Future Directions
by Sadeq Ali-Hasan-Al-Saegh, Sho Takemoto, Saeed Shafiei, Senol Yavuz, Arian Arjomandi Rad, Lukman Amanov, Ali Saad Merzah, Jawad Salman, Fabio Ius, Tim Kaufeld, Bastian Schmack, Aron-Frederik Popov, Anton Sabashnikov, Arjang Ruhparwar, Alina Zubarevich and Alexander Weymann
J. Clin. Med. 2024, 13(16), 4887; https://doi.org/10.3390/jcm13164887 - 19 Aug 2024
Cited by 1 | Viewed by 1112
Abstract
Background: The management of patients with aortic valve pathologies can sometimes fall into a “gray zone”, where the optimal treatment approach is not straightforward. The comparative benefits of sutureless aortic valve replacement (SUAVR) using the Perceval bioprosthesis versus transcatheter aortic valve implantation [...] Read more.
Background: The management of patients with aortic valve pathologies can sometimes fall into a “gray zone”, where the optimal treatment approach is not straightforward. The comparative benefits of sutureless aortic valve replacement (SUAVR) using the Perceval bioprosthesis versus transcatheter aortic valve implantation (TAVI) for the “gray zone” of aortic valve replacement procedures remain a topic of debate. To further explore this issue, we conducted a study with pairwise, single-arm, and Kaplan–Meier-based meta-analyses to compare the outcomes of SUAVR with the Perceval bioprosthesis versus TAVI, as well as to evaluate the efficacy, safety, and durability of SUAVR with the Perceval bioprosthesis over mid-term and long-term follow-up periods. Methods: The PubMed, PubMed Central, OVID Medline, Cochrane Library, Embase, and Web of Science databases were systematically searched. All study types were included, except study protocols and animal studies, without time restrictions. The final search was carried out in May 2024. Results: No statistically significant differences were observed in permanent pacemaker implantation (PPI) rates between the two groups. SUAVR showed a lower incidence of new-onset myocardial infarction but was associated with higher rates of new-onset atrial fibrillation and major bleeding. TAVI had higher rates of left bundle branch block and major vascular complications. Conclusions: Our findings show that SUAVR has a lower incidence of complications and a favorable mid-term overall survival compared to TAVI. SUAVR has more advantages compared to TAVI and can be considered a valuable and promising option for the “grey zone” of aortic valve pathologies. Full article
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