Tag Archives: aortic valve stenosis

Introduction Surgical aortic valve replacement (SAVR) is the best established treatment for severe, symptomatic aortic valve stenosis (AS), where it restores life-expectancy to levels seen in the general population.1 Ideally, patients with AS should be followed-up in a valve clinic, so that the optimal timing for performing SAVR can be determined, based on a combination of periodically assessed symptoms, signs, imaging and laboratory tests.2,3 Operating too late carries an increased risk of death and of peri-operative complications, related to (potentially irreversible) deterioration of left ventricular (LV) function from afterload mismatch.

Discussion Biomarkers have not been used routinely in clinical AS management, but recent advances look set to change this. The PROGRESSA (Metabolic Determinants of the Progression of Aortic Stenosis) study identified that a higher ratio of apolipoprotein B/apolipoprotein A‐I was associated with a 3.4-fold increase in haemodynamic progression in the younger (<70 years) AS cohort. The balance of atherogenic and anti-atherogenic lipid factors appears to play a crucial role in pathogenesis in younger patients,4 presenting a screening target. Regardless of symptom status, biomarkers have application in risk stratification. Systematic review

Introduction Severe aortic stenosis (AS) is the most common degenerative heart valve disease (HVD).1 There are growing numbers of patients with AS who are waiting for transcatheter aortic valve implantation (TAVI), as rates of degenerative HVD rise. Around 1.5 million people in the UK currently have moderate-to-severe HVD, and numbers are expected to rise to 2.7 million by 2040.2 Figure 1 shows the level of undiagnosed patients across all age groups with severe symptomatic AS.3 A significant proportion of patients who are receiving TAVI are aged 75 to 90 years, an increasing demographic in the National Health Service (NHS) as the population a

Introduction Papillary fibroelastoma (PFE) are rare intra-cardiac tumours and manifest with varied clinical presentation. This report highlights the application of transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis, compounded by PFE, as a strategy to mitigate the high risk of redo surgery in patients with multiple comorbidities. Case presentation We report a 75-year-old man who presented with multiple syncopal episodes, who had undergone previous coronary artery bypass grafting (CABG). Both left internal mammary arterial (LIMA) graft to left anterior descending (LAD) artery and saphenous vein graft to diago