The stress echocardiography with dobutamine confirms her increasing value for the patients with severe aortic stenosis and left ventricular dysfunction in a diagnosis concept by selecting the true severe stenoses and revealing stenoses overestimated by the low fow, and especially prognosis by means of the stratification of the operatory risk and the search for a contractile reserve which represent the guarantee of a survival per and postoperatoire satisfactory. As regards asymptomatic aortic stenosis the times of intervention are in reevaluation, the compliance valvulaire represent reliable means which needs confirmation for a prophylactic indication for surgery.
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Several techniques for the surgical correction of congenital supravalvular aortic stenosis have been devised. We describe the step-by-step surgical approach of a slide aortoplasty to correct localized supravalvular aortic stenosis in a 3-year-old child with Williams syndrome.
View Article and Find Full Text PDFEur Heart J Digit Health
January 2025
Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Aims: Aortic stenosis (AS) is a common and progressive disease, which, if left untreated, results in increased morbidity and mortality. Monitoring and follow-up care can be challenging due to significant variability in disease progression. This study aimed to develop machine learning models to predict the risks of disease progression and mortality in patients with mild AS.
View Article and Find Full Text PDFFront Cardiovasc Med
January 2025
School of Cardiovascular Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom.
Aortic stenosis (AS) was historically considered a disease of the left side of the heart, with the main pathophysiological impact being predominantly on the left ventricle (LV). However, progressive pressure overload in AS can initiate a cascade of extra-valvular myocardial remodeling that could also precipitate maladaptive alterations in the structure and function of the right ventricle (RV). The haemodynamic and clinical importance of these changes in patients with AS have been largely underappreciated in the past.
View Article and Find Full Text PDFOpen Heart
January 2025
Department of Cardiothoracic and Vascular Surgery, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Aims: Exercise testing remains underused in patients with aortic stenosis (AS), partly due to concerns about an exercise-induced drop in systolic blood pressure (SBP). We aimed to study the SBP response to exercise in patients with severe symptomatic AS prior to surgery and 1 year postoperatively.
Methods: Patients scheduled for aortic valve replacement due to severe symptomatic AS were enrolled at a single centre in a prospective observational cohort study.
Open Heart
January 2025
Massachusetts General Hospital, Boston, Massachusetts, USA.
Background: Accurate mortality prediction following transcatheter aortic valve implantation (TAVI) is essential for mitigating risk, shared decision-making and periprocedural planning. Surgical risk models have demonstrated modest discriminative value for patients undergoing TAVI and are typically poorly calibrated, with incremental improvements seen in TAVI-specific models. Machine learning (ML) models offer an alternative risk stratification that may offer improved predictive accuracy.
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