Treatment of Severe Aortic Valve Stenosis: Impact of Patient Sex and Life Expectancy on Treatment Choice
In adults with severe aortic stenosis, sex and age differences in symptoms and diagnosis may lead to delays in intervention. Choice of intervention partly depends on expected longevity because bioprosthetic valves have limited durability, particularly in younger patients. Current guidelines recommen...
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| Format: | Article |
| Language: | English |
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Radcliffe Medical Media
2022-12-01
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| Series: | European Cardiology Review |
| Online Access: | https://www.ecrjournal.com/articleindex/ecr.2022.31 |
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| author | Nina Rashedi Catherine M Otto |
| author_facet | Nina Rashedi Catherine M Otto |
| author_sort | Nina Rashedi |
| collection | DOAJ |
| description | In adults with severe aortic stenosis, sex and age differences in symptoms and diagnosis may lead to delays in intervention. Choice of intervention partly depends on expected longevity because bioprosthetic valves have limited durability, particularly in younger patients. Current guidelines recommend the following: a mechanical valve in younger adults (aged <50 years) if lifelong anticoagulation is possible and acceptable and a valve-sparing procedure is not possible; surgical mechanical or bioprosthetic aortic valve replacement (SAVR) in adults aged 50–65 years; and transcatheter aortic valve implantation (TAVI) for those aged >80 years based on lower mortality and morbidity compared to SAVR and adequate valve durability. For patients aged 65–80 years, the choice between TAVI and a bioprosthetic SAVR depends on expected longevity, which is greater in women than men, as well as associated cardiac and noncardiac conditions, valvular and vascular anatomy, estimated risk of SAVR versus TAVI and expected complications and patient preferences. |
| format | Article |
| id | doaj-art-d9ee0f047c8446e3b5cac99d45cd9d6a |
| institution | Kabale University |
| issn | 1758-3756 1758-3764 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | European Cardiology Review |
| spelling | doaj-art-d9ee0f047c8446e3b5cac99d45cd9d6a2024-12-14T16:03:59ZengRadcliffe Medical MediaEuropean Cardiology Review1758-37561758-37642022-12-011710.15420/ecr.2022.31Treatment of Severe Aortic Valve Stenosis: Impact of Patient Sex and Life Expectancy on Treatment ChoiceNina Rashedi0Catherine M Otto1Division of Cardiology, University of Washington School of Medicine, Seattle, WA, USDivision of Cardiology, University of Washington School of Medicine, Seattle, WA, USIn adults with severe aortic stenosis, sex and age differences in symptoms and diagnosis may lead to delays in intervention. Choice of intervention partly depends on expected longevity because bioprosthetic valves have limited durability, particularly in younger patients. Current guidelines recommend the following: a mechanical valve in younger adults (aged <50 years) if lifelong anticoagulation is possible and acceptable and a valve-sparing procedure is not possible; surgical mechanical or bioprosthetic aortic valve replacement (SAVR) in adults aged 50–65 years; and transcatheter aortic valve implantation (TAVI) for those aged >80 years based on lower mortality and morbidity compared to SAVR and adequate valve durability. For patients aged 65–80 years, the choice between TAVI and a bioprosthetic SAVR depends on expected longevity, which is greater in women than men, as well as associated cardiac and noncardiac conditions, valvular and vascular anatomy, estimated risk of SAVR versus TAVI and expected complications and patient preferences.https://www.ecrjournal.com/articleindex/ecr.2022.31 |
| spellingShingle | Nina Rashedi Catherine M Otto Treatment of Severe Aortic Valve Stenosis: Impact of Patient Sex and Life Expectancy on Treatment Choice European Cardiology Review |
| title | Treatment of Severe Aortic Valve Stenosis: Impact of Patient Sex and Life Expectancy on Treatment Choice |
| title_full | Treatment of Severe Aortic Valve Stenosis: Impact of Patient Sex and Life Expectancy on Treatment Choice |
| title_fullStr | Treatment of Severe Aortic Valve Stenosis: Impact of Patient Sex and Life Expectancy on Treatment Choice |
| title_full_unstemmed | Treatment of Severe Aortic Valve Stenosis: Impact of Patient Sex and Life Expectancy on Treatment Choice |
| title_short | Treatment of Severe Aortic Valve Stenosis: Impact of Patient Sex and Life Expectancy on Treatment Choice |
| title_sort | treatment of severe aortic valve stenosis impact of patient sex and life expectancy on treatment choice |
| url | https://www.ecrjournal.com/articleindex/ecr.2022.31 |
| work_keys_str_mv | AT ninarashedi treatmentofsevereaorticvalvestenosisimpactofpatientsexandlifeexpectancyontreatmentchoice AT catherinemotto treatmentofsevereaorticvalvestenosisimpactofpatientsexandlifeexpectancyontreatmentchoice |