Managing the challenge of a small aortic annulus in patients with severe aortic stenosis.

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-12-10 DOI:10.1080/14779072.2023.2271395

Alicia Prieto-Lobato, Jorge Nuche, Marisa Avvedimento, Jean-Michel Paradis, Eric Dumont, Dimitris Kalavrouziotis, Siamak Mohammadi, Josep Rodés-Cabau

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Abstract

Introduction: Small aortic annulus (SAA) poses a challenge in the management of patients with severe aortic stenosis requiring aortic valve replacement - both surgical and transcatheter - since it has been associated with worse clinical outcomes.

Areas covered: This review aims to comprehensively summarize the available evidence regarding the management of aortic stenosis in patients with SAA and discuss the current controversies as well as future perspectives in this field.

Expert opinion: It is paramount to agree in a common definition for diagnosing and properly treating SAA patients, and for that purpose, multidetector computer tomography is essential. The results of recent trials led to the expansion of transcatheter aortic valve replacement among patients of all the surgical-risk spectrum, and the choice of treatment (transcatheter, surgical) should be based on patient comorbidities, anatomical characteristics, and patient preferences.

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处理严重主动脉瓣狭窄患者的小主动脉瓣环挑战。

引言：小主动脉瓣环（SAA）对主动脉瓣置换术（包括外科手术和经导管手术）构成了挑战，因为它与更差的预后和结果有关。涵盖领域：本综述旨在全面总结关于小主动脉瓣环患者主动脉狭窄治疗的现有证据，并讨论当前的争议以及这一相关问题的未来前景。专家意见：在诊断和正确治疗SAA患者方面达成一个共同的定义至关重要，为此，多探测器计算机断层扫描至关重要。由于最近的试验将经导管主动脉瓣置换术的使用范围扩大到所有手术风险范围，治疗的选择应基于患者的合并症、解剖特征和患者的偏好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.70

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0.00%

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期刊介绍： Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.

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