Acute advanced aortic stenosis.
Marisa AvvedimentoDomenico AngellottiFederica IlardiAttilio LeoneMaria ScalamognaDomenico Simone CatielloRachele ManzoAndrea MarianiMaddalena Immobile MolaroFiorenzo SimonettiCarmen Anna Maria SpaccarotellaRaffaele PiccoloGiovanni EspositoAnna FranzonePublished in: Heart failure reviews (2023)
Acute decompensation often represents the onset of symptoms associated with severe degenerative aortic stenosis (AS) and usually complicates the clinical course of the disease with a dismal impact on survival and quality of life. Several factors may derange the faint balance between left ventricular preload and afterload and precipitate the occurrence of symptoms and signs of acute heart failure (HF). A standardized approach for the management of this condition is currently lacking. Medical therapy finds very limited application in this setting, as drugs usually indicated for the control of acute HF might worsen hemodynamics in the presence of AS. Urgent aortic valve replacement is usually performed by transcatheter than surgical approach whereas, over the last decades, percutaneous balloon valvuloplasty gained renewed space as bridge to definitive therapy. This review focuses on the pathophysiological aspects of acute advanced AS and summarizes current evidence on its management.
Keyphrases
- aortic stenosis
- aortic valve replacement
- left ventricular
- transcatheter aortic valve replacement
- ejection fraction
- transcatheter aortic valve implantation
- aortic valve
- liver failure
- acute heart failure
- respiratory failure
- drug induced
- aortic dissection
- coronary artery disease
- heart failure
- healthcare
- hepatitis b virus
- stem cells
- acute myocardial infarction
- squamous cell carcinoma
- hypertrophic cardiomyopathy
- extracorporeal membrane oxygenation
- intensive care unit
- physical activity
- cell therapy
- replacement therapy
- depressive symptoms