Treatment of Severe Aortic Stenosis

Severe valvular aortic stenosis (AS) is an aortic valve area of less than 1.0 cm2. Angina pectoris, syncope or near syncope, and congestive heart failure (CHF) are the 3 classic manifestations of severe AS. Patients with symptomatic severe valvular AS have a poor prognosis. Ross and Braunwald found that the average survival rate was 3 years after the onset of angina pectoris in patients with severe AS. Ross and Braunwald reported that the average survival rate after the onset of syncope in patients with severe AS was 3 years. 

Ross and Braunwald showed that the average survival rate after the onset of CHF in patients with severe AS was 1.5 to 2 years. In a prospective study, at 19-month follow-up (range 2 to 36 months), 90% of 30 patients with CHF associated with unoperated severe AS and a normal left ventricular ejection fraction (LVEF) were dead. At 13-month follow-up (range 2 to 24 months), 100% of 18 patients with CHF associated with unoperated severe AS and an abnormal LVEF were dead. Read more..............