Quality-of-life implications of immediate surgery and watchful waiting in asymptomatic aortic stenosis: a decision-analytic model.

The conundrum of watchful waiting versus pre-emptive surgery in asymptomatic aortic stenosis: are we any closer to an answer?

Asymptomatic severe aortic stenosis with left ventricular dysfunction: watchful waiting or valve replacement?

Aortic stenosis (AS) is the most common valvular heart disorder in older adults. Patients with severe AS are generally treated nonsurgically if asymptomatic and referred to aortic valve replacement when symptoms develop. However, patients with severe asymptomatic AS with left ventricular dysfunction may benefit from early aortic valve replacement. Although operative mortality in patients with s...

Exercise hemodynamics and risk assessment in asymptomatic aortic stenosis.

More than half a century ago, in the American Journal of Cardiology, Dr Paul Wood aptly described aortic stenosis (AS) as “a simple mechanical fault which, if severe enough, imposes a heavy burden on the left ventricle and sooner or later overcomes it.”1 Our subsequent understanding of the pathophysiology of AS, using more sophisticated tools than those at Dr Wood’s disposal, has confirmed his ...

Predicting outcome in patients with asymptomatic aortic stenosis.

Although the annual risk of cardiovascular mortality has been well described for individuals with symptomatic aortic stenosis, the morbidity and mortality for those with asymptomatic severe aortic stenosis is not as well known. Currently the American Heart Association/American College of Cardiology recommends a “watchful waiting” strategy for those with asymptomatic aortic stenosis.1 This invol...

Valvular Aortic Stenosis

Standard echocardiographic evaluation of aortic stenosis (AS) severity includes measurement of aortic velocity, mean transaortic pressure gradient, and continuity equation valve area. Although these measures are adequate for decision making in most patients, there is no single value that defines severe stenosis. Aortic stenosis affects not just the valve, but the entire vascular system, includi...