Archive for the 'Aortic Stenosis' Category

14 May

The Natural History and Rate of Progression of Aortic Stenosis: Conclusion

The concept of a dynamic aortic valve orifice area needs validation. If veritable, an assessment of valve pliability derived by Doppler-determined changes in the instantaneous orifice area may provide important clinical information with respect to the relationship of hemodynamic severity and clinical symptoms. In addition, it may prove to be a more sensitive marker of […]

12 May

The Natural History and Rate of Progression of Aortic Stenosis: Thoughts for the Future

Torricelli’s law, the first hydraulic formula that the Gorlin’s used to develop their formula for the calculation of valve area, states that flow is directly proportional to orifice area and flow velocity. Measurements of aortic valve area are made at a single point in time, and thus are based on the assumption that orifice area […]

10 May

The Natural History and Rate of Progression of Aortic Stenosis: Outcome

Although it is generally accepted that patients presenting for coronary artery bypass grafting with moderate or severe aortic stenosis (regardless of symptom status) undergo concomitant aortic valve replacement, the treatment of patients presenting for myocardial revascularization with coexisting asymptomatic mild aortic stenosis remains challenging. Given the bimodal rate of progression, it is no wonder that […]

08 May

The Natural History and Rate of Progression of Aortic Stenosis: Results

Peter et al prospectively followed up 49 adults with aortic stenosis. At entry, the average peak instantaneous gradient was 38±15 mm Hg (range, 16 to 78 mm Hg). Patients were followed up for a mean duration of 32 months. The peak transaortic pressure gradient changed by +16 to +93 mm Hg, corresponding to a mean […]

06 May

The Natural History and Rate of Progression of Aortic Stenosis: Valvular aortic stenosis

Otto et al prospectively followed up 42 adults with valvular aortic stenosis for a mean duration of 20 months. The average Doppler-derived peak systolic gradient was 54 mm Hg (range, 27 to 108 mm Hg). The peak transaortic pressure gradient changed by +12 mm Hg/yr ( — 10 to +34 mm Hg) and the mean […]

04 May

The Natural History and Rate of Progression of Aortic Stenosis: Stenosis Progression

A concern, identified in the studies cited above, is that a small proportion of asymptomatic patients may progress very rapidly to develop symptoms and then die suddenly. If, however, one could identify reliable predictors to the rate of progression of aortic stenosis, then surgical consideration may be given to these high-risk, yet asymptomatic patients. In […]

02 May

The Natural History and Rate of Progression of Aortic Stenosis: Severe aortic stenosis

A cohort of 51 asymptomatic patients with severe aortic stenosis were followed up by Kelly and coworkers for a mean of 17 months. A Doppler-derived peak systolic pressure gradient of ^50 mm Hg was used to define severe aortic stenosis. The aortic valve area was not calculated in this study. Twenty-one (41%) of the patients […]

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