Syncope and sudden death in aortic stenosis

Schwartz, Lewis S.; Goldfischer, Jerome D.; Sprague, Grover J.; Schwartz, Sidney P.

doi:10.1016/0002-9149(69)90025-3

Cited by 117 publications

(44 citation statements)

References 30 publications

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“…This complexity and augmented diastolic dysfunction leads to pulmonary congestion and dyspnea in severe AS. [23]. Inappropriate vasodilation, the result of reflexes triggered by LV baroreceptors [24] and occurring during or just after exercise, is thought to be the mechanism in most cases [25].…”

Section: Asymptomatic Versus Symptomatic Asmentioning

confidence: 99%

Symptomatic presentations of severe aortic stenosis

Park

2017

Precis Future Med

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Aortic stenosis (AS) is the most common type of valvular heart disease. A manifestation of ageing, the disorder is becoming more frequent as the average age of the population increases. Onset of cardinal manifestation of AS-angina, syncope, and heart failureremains the major demarcation point in the disease's course. It has been well described that patients' survival is limited once they develop symptoms from AS and survival after the onset of a symptom depends on what type of symptom a patient develops. Knowing how the pathophysiology of AS causes typical symptoms and death is paramount to understanding the disease. We discuss these issues in this review.

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Section: Asymptomatic Versus Symptomatic Asmentioning

confidence: 99%

Symptomatic presentations of severe aortic stenosis

Park

2017

Precis Future Med

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“…The mechanisms of angina and CHF were mentioned above, but there is no clear mechanism for syncope. One theory postulates: " there is a decrease in brain perfusion during and after exercise in patients with severe AS due to the small outflow orifice (Schwartz, Goldfischer, Sprague, & Schwartz, 1969)". Late manifestations of AS might include atrial fibrillation and pulmonary hypertension.…”

Section: Clinical Presentationmentioning

confidence: 99%

015 * Propensity Score Analysis of Outcomes Following Minimally Invasive Versus Conventional Aortic Valve Replacement

Shehada

Voß

Elhmidi

et al. 2014

Interactive CardioVascular and Thoracic Surgery

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“…Aortic valve insufficiency as well as aortic valve stenosis has been associated with both prolonged atrioventricular conduction times and higher degrees of atrioventricular conduction disorders (20)(21)(22). The anatomical vicinity of the aortic valve and the atrioventricular node as well as the His bundle will lead to complete atrioventricular block in 5.7% and new left bundle branch block in 18% at long term after open-heart surgery (23,24).…”

Section: Conduction Disordersmentioning

confidence: 99%

ECG Abnormalities after Transcatheter Aortic Valve Implantation

Akın¹,

Nienaber²

2014

Arch Cardiovasc Imaging

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Transcatheteraortic valve implantation, first introduced in 2002, has been established as an alternative modality for patients deemed not suitable for open-heart surgery. The anatomical vicinity of the atrioventricular node and the His bundle to the non-coronary and rightcoronary aortic cusps predisposes patients to conduction abnormalities in case of severe calcification or mechanical trauma during valve implantation. However, the two evaluated valves (CoreValve and Edwards SAPIEN valve) have different rates of these complications, mainly driven by their respective geometry. Currently, there is ongoing evaluation of the true rate of conduction disorders and their clinical relevance or durability. The initial experience of fatal outcomes with conduction disorders such as complete atrioventricular block has increased the rate of subsequent pacemaker implantation up to 50%. However, prophylactic pacemaker implantation is associated with several possible complications. Thus, there is a need for further data from large-scale series taking into account the true rate of clinically relevant conduction disorders.Keywords:Heart Valve Prosthesis Implantation; Atrioventricular Block; Bundle-Branch Block; Pacemaker; Artificial; Bundle of His Implication for health policy/practice/research/medical education: The transcatheter aortic valve implantation is an established tool for the treatment of multimorbid patients suffering from severe symptomatic aortic valve stenosis. However, it is much more associated with with pacemaker dependence as compared to classic open aortic valve surgery. Within this review we try to explain the differences between the interventional procedure and the open surgical procedure as well as the difference between different vlave types.

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Syncope and sudden death in aortic stenosis

Cited by 117 publications

References 30 publications

Symptomatic presentations of severe aortic stenosis

Symptomatic presentations of severe aortic stenosis

015 * Propensity Score Analysis of Outcomes Following Minimally Invasive Versus Conventional Aortic Valve Replacement

ECG Abnormalities after Transcatheter Aortic Valve Implantation

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