Treatment is Urgent and Aortic Valve Replacement is Effective
There are no medications to reverse or slow the progression of AS. AVR is the standard of care. Because of the risk of sudden death, AVR should be performed promptly after the onset of symptoms.2 Without timely aortic valve replacement, patients with severe AS and symptoms have high mortality: mortality is 3% to 4% soon after symptoms appear and 7% among patients on a waiting list for AVR. In contrast, mortality in a fit patient is 1% to 2% after AVR.3
In recent decades, surgical AVR has consistently produced outstanding results in prolonging life and improving quality of life.4, 5, 6 Even among patients over the age of 80 years, functional outcomes have been excellent in patients after AVR.6 Survival is good, with 60% to 65% of patients who underwent AVR alive five years later,5, 7 with improved quality of life.4 AVR takes patients out of full-time care or sedentary lifestyles, enabling a return to independence.
- Brown ML, Pellikka PA, Schaff HV, et al. The benefits of early valve replacement in asymptomatic patients with severe aortic stenosis.
J Thorac Cardiovasc Surg 2008; 135(2): 308-15.
- Bonow RO, Carabello BA, Chatterjee K, et al.; 2006 Writing Committee Members; American College of Cardiology/American Heart Association Task Force. 2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation 2008;118:e523-661.
- Chambers JB. Aortic stenosis. Eur J Echocardiogr 2009;10:i11-9.
- Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC); European Association for Cardio-Thoracic Surgery (EACTS), Vahanian A, Alfieri O, Andreotti F, et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J 2012;33:2451-96.
- Conti V, Lick SD. Cardiac surgery in the elderly: indications and management options to optimize outcomes. Clin Geriatr Med 2006;22:559-74.
- Sundt TM, Bailey MS, Moon MR, et al. Quality of life after aortic valve replacement at the age of >80 years. Circulation 2000;102:III70-4.
- Chiappini B, Camurri N, Loforte A, et al. Outcome after aortic valve replacement in octogenarians. Ann Thorac Surg 2004;78:85-9.