: Acute decompensation often represents the onset of symptoms associated with severe degenerative aortic stenosis (AS) and usually complicates the clinical course of the disease with a dismal impact on survival and quality of life. Several factors may derange the faint balance between left ventricular preload and afterload and precipitate the occurrence of symptoms and signs of acute heart failure (HF). A standardized approach for the management of this condition is currently lacking. Medical therapy finds very limited application in this setting, as drugs usually indicated for the control of acute HF might worsen hemodynamics in the presence of AS. Urgent aortic valve replacement is usually performed by transcatheter than surgical approach whereas, over the last decades, percutaneous balloon valvuloplasty gained renewed space as bridge to definitive therapy. This review focuses on the pathophysiological aspects of acute advanced AS and summarizes current evidence on its management.
Acute advanced aortic stenosis / Avvedimento, Marisa; Angellotti, Domenico; Ilardi, Federica; Leone, Attilio; Scalamogna, Maria; Castiello, Domenico Simone; Manzo, Rachele; Mariani, Andrea; Immobile Molaro, Maddalena; Simonetti, Fiorenzo; Spaccarotella, Carmen Anna Maria; Piccolo, Raffaele; Esposito, Giovanni; Franzone, Anna. - In: HEART FAILURE REVIEWS. - ISSN 1573-7322. - 28:5(2023), pp. 1101-1111. [10.1007/s10741-023-10312-7]
Acute advanced aortic stenosis
Avvedimento, Marisa;Angellotti, Domenico;Ilardi, Federica;Leone, Attilio;Scalamogna, Maria;Castiello, Domenico Simone;Manzo, Rachele;Mariani, Andrea;Immobile Molaro, Maddalena;Simonetti, Fiorenzo;Spaccarotella, Carmen Anna Maria;Piccolo, Raffaele;Esposito, Giovanni;Franzone, Anna
2023
Abstract
: Acute decompensation often represents the onset of symptoms associated with severe degenerative aortic stenosis (AS) and usually complicates the clinical course of the disease with a dismal impact on survival and quality of life. Several factors may derange the faint balance between left ventricular preload and afterload and precipitate the occurrence of symptoms and signs of acute heart failure (HF). A standardized approach for the management of this condition is currently lacking. Medical therapy finds very limited application in this setting, as drugs usually indicated for the control of acute HF might worsen hemodynamics in the presence of AS. Urgent aortic valve replacement is usually performed by transcatheter than surgical approach whereas, over the last decades, percutaneous balloon valvuloplasty gained renewed space as bridge to definitive therapy. This review focuses on the pathophysiological aspects of acute advanced AS and summarizes current evidence on its management.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.