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AORTIC STENOSIS

Aortic Stenosis (AS) is the most common primary valve disease leading to surgery or catheter intervention in Europe and North America.1 It is present in approximately 2% of the general population with a rising prevalence in the elderly (up to 6% in patients above 85 years old).2-4

Symptomatic AS has significant effects on a patient’s health and quality of life5,6 and many will have cardiovascular and other comorbidities, for example, other valvular diseases, diabetes mellitus, hypertension and peripheral vascular disease.7-11

Aortic Stenosis is the narrowing of the aortic orifice, typically as a result of degeneration and calcification of the valve leaflets.2

A normal aortic valve has an orifice of 3 to 4 cm.2,12 Narrowing of the valve becomes hemodynamically significant when the valve area is reduced to about 1 cm.2 AS leads to a less optimal flow of blood from the ventricle into the aorta and may result in Left Ventricle (LV) hypertrophy and decreased systemic and coronary circulation.

 

Anatomy of the aortic valve: types of aortic stenosis

Normal

Mild-to-Moderate Aortic Stenosis

Severe Aortic Stenosis

AS is a progressive disease. While patients with AS may initially be asymptomatic, further progression is typically associated with symptoms and poor prognosis.13,14 AS is associated with a significant risk of mortality, and survival is markedly reduced after the onset of symptoms.15

Natural history of AS:16
 

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References
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  2. Lindroos M, Kupari M, Heikkilä J et al. Prevalence of aortic valve abnormalities in the elderly: an echocardiographic study of a random population sample. J Am Coll Cardiol. 1993;21(5):1220–1225. doi.org/10.1016/0735-1097(93)90249-Z.
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