Aortic valve disease

Rayner, J.; Coffey, Sean; Newton, James D.; Prendergast, Bernard

doi:10.1111/ijcp.12471

Cited by 9 publications

(11 citation statements)

References 44 publications

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“…Este hecho, asociado al envejecimiento progresivo y exponencial de la población hace que sea actualmente la causa más frecuente de estenosis aórtica. Otras causas que pueden originar estenosis valvular aórtica son la reumática (actualmente en descenso por el empleo y optimización de antibióticos) y la congénita, donde predomina la valvulopatía bicúspide sobre las demás, ocasionando además estenosis y clínica en pacientes de mediana edad y severa hipertrofia ventricular (Rayner, Coffey, Newton, y Prendergast, 2014).…”

Section: Situación Actual Del Estado De La Cuestión Estudiadaunclassified

Regresión y remodelado de cámaras cardíacas en el seguimiento tras el implante de prótesis aórticas transcatéter

Taboada

2020

EJHR

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El reemplazo valvular aórtico transcatéter (TAVR) ha aumentado debido al envejecimiento y riesgo de la población. Algunos estudios han mostrado resultados prometedores sobre su resultado hemodinámico con tasas adecuadas de morbilidad y mortalidad. Sin embargo, se desconoce el impacto de estas bioprótesis sobre la masa ventricular izquierda (LVM). El objetivo principal de nuestro estudio fue analizar la regresión de LVM y el remodelado ventricular con estas bioprótesis en pacientes del mundo real sometidos a recambio valvular aórtico vía transcatéter. Desde enero de 2010 a diciembre de 2011, 61 pacientes fueron sometidos a reemplazo valvular aórtico transcatéter por estenosis aórtica severa. Se recogieron y analizaron las características demográficas, clínicas y los parámetros hemodinámicos, electrocardiográficos y ecocardiográficos. Los resultados son: observamos diferencias estadísticamente significativas pre y postoperatorio en los parámetros electrocardiográficos, expresados por criterios de Sokolow-Lyon, Cornell y productos de duraciónvoltaje; el tamaño del tabique interventricular mostró una disminución de 14 mm a 11 mm y la masa ventricular indexada mostró una disminución de hasta 30 g / m2, es decir, se redujo de 145,5 g / m2 a 115 g / m2. Las conclusiones son: el remodelado ventricular es favorable en los grupos TAVR medidos por ecocardiografía y criterios eléctricos, mejorando la contractilidad y la supervivencia libre de eventos al año de seguimiento.

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Section: Situación Actual Del Estado De La Cuestión Estudiadaunclassified

Regresión y remodelado de cámaras cardíacas en el seguimiento tras el implante de prótesis aórticas transcatéter

Taboada

2020

EJHR

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“…Aortic stenosis (AS), which leads to symptoms of chronic heart failure, is the most common valvular disease in western countries among people >75 years of age. Because of our ageing population (1), the prevalence of AS is increasing, and the need for treatment will double during the next 50 years (2). Once a patient becomes symptomatic, the 2‐year mortality rate for developing severe AS without surgery is 50% (3).…”

Section: Introductionmentioning

confidence: 99%

Patients' experiences of everyday living before and after transcatheter aortic valve implantation

Lysell

Wolf

2020

Scandinavian Caring Sciences

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Background Aortic stenosis (AS) is the most common valvular disease in western countries. Unless treated, it is associated with a poor prognosis. Surgical aortic valve replacement, the gold‐standard approach, aims to increase survival and improve quality of life. In recent years, though, transcatheter aortic valve implantation (TAVI) has become the treatment of choice in elderly, high‐risk patients who are denied open surgery. To date, however, little is known about their personal psychological experience after undergoing TAVI. Aim This study aimed to explore patients’ experiences during everyday life before and after TAVI. Method Altogether, 14 elderly Swedish patients (9 women, 5 men), treated with TAVI, were interviewed between 2 and 6 months after the implantation. The interviews were analysed using qualitative content analysis. Results Analysis of the participants’ experiences was divided into two domains: before and after, that is, life with AS vs. life after TAVI. From these domains, four categories were derived: (1) adapting to the deteriorating self; (2) feeling disconnected; (3) reconstruction of self; and (4) processing disappointment. Conclusions Transcatheter aortic valve implantation involves not only adding years to life but also adding life to years. The urge to live an autonomous life in a social context with others is an important argument for undergoing a TAVI procedure. Despite severe illness and demanding rehabilitation, elderly TAVI patients have the ability to regain independence and rebuild their lives when they base their decision to undergo TAVI on personal goals. These findings might be helpful when implementing person‐centred care.

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“…As a result of an ageing population, the prevalence of AS is increasing. 1 AS is most commonly caused by a degenerative calcification process leading to leaflet immobility, which in turn causes impaired blood flow through the heart and symptoms of pressure overload. 2 The three cardinal symptoms of AS, indicating the need for clinical intervention, are breathlessness, chest pain and dizziness or syncope.…”

Section: Introductionmentioning

confidence: 99%

“… 2 The three cardinal symptoms of AS, indicating the need for clinical intervention, are breathlessness, chest pain and dizziness or syncope. 1 An unknown proportion of patients remains asymptomatic for several years despite the presence of haemodynamically severe disease. 3 Symptomatic AS has been associated with a sharp increase in death risk with an estimated 50% death rate at 2 years unless aortic valve replacement (AVR) is performed.…”

Section: Introductionmentioning

confidence: 99%

Self-reported health status, treatment decision and survival in asymptomatic and symptomatic patients with aortic stenosis in a Western Norway population undergoing conservative treatment: a cross-sectional study with 18 months follow-up

Oterhals

Haaverstad²,

Nordrehaug

et al. 2017

BMJ Open

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ObjectivesTo investigate symptoms and self-reported health of patients conservatively treated for aortic stenosis (AS) and to identify factors associated with treatment decision and patient outcomes.DesignA cross-sectional survey with an 18-month follow-up.SettingOne tertiary university hospital in Western Norway.ParticipantsIn all, 1436 patients were diagnosed with AS between 2000 and 2012, and those 245 still under conservative treatment in 2013 were included in this study.Primary and secondary outcome measuresPrimary outcome measures were symptoms and self-reported health status. Secondary outcomes were treatment decision and patient survival after 18 months.ResultsA total of 136 patients with mean (SD) age 79 (12) years, 52% men responded. Among conservatively treated patients 77% were symptomatic. The symptom most frequently experienced was dyspnoea. Symptomatic patients reported worse physical and mental health compared with asymptomatic patients (effect size 1.24 and 0.74, respectively). In addition, symptomatic patients reported significantly higher levels of anxiety and depression compared with asymptomatic patients. However, symptom status did not correlate with haemodynamic severity of AS. After 18 months, 117 (86%) were still alive, 20% had undergone surgical aortic valve replacement (AVR) and 7% transcatheter aortic valve implantation (TAVI). When adjusting for age, gender, symptomatic status, severity of AS and European system for cardiac operative risk evaluation (EuroSCORE), patients with severe AS had more than sixfold chance of being scheduled for AVR or TAVI compared with those with moderate AS (HR 6.3, 95% CI 1.9 to 21.2, p=0.003). Patients with EuroSCORE ≥11 had less chance for undergoing AVR or TAVI compared with those with EuroSCORE ≤5 (HR 0.06, 95% CI 0.01 to 0.46, p=0.007).ConclusionsSymptoms affected both physical and mental health in conservatively treated patients with AS. Many patients with symptomatic severe AS are not scheduled for surgery, despite the recommendations in current guidelines. The referral practice for AVR is a path for further investigation.

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Aortic valve disease

Cited by 9 publications

References 44 publications

Regresión y remodelado de cámaras cardíacas en el seguimiento tras el implante de prótesis aórticas transcatéter

Regresión y remodelado de cámaras cardíacas en el seguimiento tras el implante de prótesis aórticas transcatéter

Patients' experiences of everyday living before and after transcatheter aortic valve implantation

Self-reported health status, treatment decision and survival in asymptomatic and symptomatic patients with aortic stenosis in a Western Norway population undergoing conservative treatment: a cross-sectional study with 18 months follow-up

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