The natural history of aortic stenosis in adults

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

“…W starszych badaniach dotyczących historii naturalnej wad zastawowych nagły zgon wystąpił u 15-20% dorosłych pacjentów ze stenozą aortalną średnio w wieku 60 lat. Wśród objawowych nieoperowanych pacjentów nagły zgon występuje z częstością do 34% [628,629]. W jednym z badań 60% wszystkich zgonów sercowych, które wystąpiły w trakcie niechirurgicznej obserwacji pacjentów z ciężką niedomykalnością mitralną, miało charakter nagły [630].…”

Sex Differences in Severe Aortic Stenosis ― Clinical Presentation and Mortality ―

“…The mortality outcome after the enrollment may vary with duration from the onset of symptoms to enrollment in symptomatic patients. 23 Third, in this observational study, the possibility of residual confounding and selection bias could not be ruled out. Fourth, surgical treatment was performed more often in men than in women.…”

Risk and Outcome of Aortic Valve Surgery in the Transcatheter Valve Era: The Gender Aspect

“…9) Mortality rates from onset of symptoms are >25% in the first year and -50% after two years with a high risk of sudden death. 3) SAVR is the indicated therapy and showed good results in the last decades with 3-year-survival of 87%. 10) Comorbidities, such as low left ventricular function, chronic obstructive pulmonary disease (COPD) with the need for permanent bronchodilatory drug intake, peripheral vascular disease (PVD) or renal insufficiency as well as higher age are associated with a significantly higher mortality risk with conventional surgery and can impede causal therapy.…”

“…1,2) Before the TAVI-era, patients considered inoperable due to their medical co-morbidities or high age were referred to conservative medical treatment associated with poor short term survival. 3) Since Cribier et al performed the first TAVI in 2002, this method has been improved over the last decade and is performed at continuously increasing institutions all over the world. 4,5) According to a position statement of the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), patients should be evaluated for TAVI or SAVR by a multidisciplinary "heart team" consisting of interventional cardiologists and heart surgeons regarding anatomical feasibility and individual risk profile.…”