Ahmed Abdalwahab, Muntaser Omari, Mohammad Alkhalil
{"title":"Aortic Valve Intervention in Patients with Aortic Stenosis and Small Annulus.","authors":"Ahmed Abdalwahab, Muntaser Omari, Mohammad Alkhalil","doi":"10.31083/RCM26738","DOIUrl":null,"url":null,"abstract":"<p><p>Over the last two decades, the management of aortic stenosis has undergone significant transformation due to developments in surgical techniques and the introduction of transcatheter aortic valve implantation (TAVI). These transformations have enabled improved patient selection and treatments to be tailored based on individual clinical and anatomical characteristics. Both surgical and transcatheter options have resulted in reduced mortality and enhanced quality of life for patients with aortic stenosis. Nonetheless, treating patients with small aortic annulus remains challenging despite advances in current technology. The insertion of a small prosthetic valve, leading to patient prosthetic mismatch, has been associated with heart failure hospitalization, early structural valve degeneration, and long-term mortality. Although aortic root enlargement was historically employed to address this issue, stentless and sutureless valves in the supra-annular position and, more recently, TAVI have emerged as alternative treatments for patients with small annulus and severe aortic stenosis. This review will provide an overview of the prevalence and anatomical characteristics of patients with aortic stenosis and small annulus. Additionally, we will discuss current treatment options, including surgery and TAVI, used to mitigate procedural and long-term adverse outcomes in this group.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 3","pages":"26738"},"PeriodicalIF":1.9000,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951497/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reviews in cardiovascular medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.31083/RCM26738","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Over the last two decades, the management of aortic stenosis has undergone significant transformation due to developments in surgical techniques and the introduction of transcatheter aortic valve implantation (TAVI). These transformations have enabled improved patient selection and treatments to be tailored based on individual clinical and anatomical characteristics. Both surgical and transcatheter options have resulted in reduced mortality and enhanced quality of life for patients with aortic stenosis. Nonetheless, treating patients with small aortic annulus remains challenging despite advances in current technology. The insertion of a small prosthetic valve, leading to patient prosthetic mismatch, has been associated with heart failure hospitalization, early structural valve degeneration, and long-term mortality. Although aortic root enlargement was historically employed to address this issue, stentless and sutureless valves in the supra-annular position and, more recently, TAVI have emerged as alternative treatments for patients with small annulus and severe aortic stenosis. This review will provide an overview of the prevalence and anatomical characteristics of patients with aortic stenosis and small annulus. Additionally, we will discuss current treatment options, including surgery and TAVI, used to mitigate procedural and long-term adverse outcomes in this group.
期刊介绍:
RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.