Patel, Kush P;
Chahal, Anwar;
Mullen, Michael J;
Rathod, Krishnaraj;
Baumbach, Andreas;
Lloyd, Guy;
Treibel, Thomas A;
... Khanji, Mohammed Y; + view all
(2023)
Acute Decompensated Aortic Stenosis: State of the Art Review.
Current Problems in Cardiology
, 48
(1)
, Article 101422. 10.1016/j.cpcardiol.2022.101422.
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Abstract
Aortic stenosis (AS) is a progressive disease that carries a poor prognosis. Patients are managed conservatively until satisfying an indication for transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR) based on AS severity and the presence of symptoms or adverse impact on the myocardium. Up to 1 in 3 TAVIs are performed for patients with acute symptoms of dyspnea at rest, angina, and/or syncope - termed acute decompensated aortic stenosis (ADAS) and require urgent aortic valve replacement. These patients have longer hospital length of stay, undergo physical deconditioning, and have a higher rate of acute kidney injury and mortality compared to stable patients with less severe symptoms. There is an urgent need to prevent ADAS and to deliver pathways to manage and improve ADAS-related outcomes. We provide here a contemporary review on epidemiological and pathophysiological aspects of ADAS, with a focus on the impact of ADAS from clinical and economic perspectives. We offer a global overview of the available evidence for treatment of ADAS and with priorities suggested for addressing current gaps in the literature and unmet clinical needs to improve outcomes for AS patients.
| Type: | Article |
|---|---|
| Title: | Acute Decompensated Aortic Stenosis: State of the Art Review |
| Location: | Netherlands |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.cpcardiol.2022.101422 |
| Publisher version: | https://doi.org/10.1016/j.cpcardiol.2022.101422 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Aortic stenosis, decompensated aortic stenosis, transcatheter aortic valve implantation, surgical aortic valve replacement, risk stratification, cardiogenic shock |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10193825 |
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