1. Outcomes in asymptomatic, severe aortic stenosis
- Author
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Helge Skulstad, Kaspar Broch, Anette Borger Kvaslerud, Lars Gullestad, Amjad Iqbal Hussain, Arnt E. Fiane, Andreas Auensen, Kenan Santic, and Lars Aaberge
- Subjects
Male ,Aortic valve ,Cardiovascular Procedures ,Epidemiology ,Cardiovascular Medicine ,Severity of Illness Index ,Vascular Medicine ,Coronary artery disease ,Medical Conditions ,Endocrinology ,Aortic valve replacement ,Medicine and Health Sciences ,Coronary Heart Disease ,Aged, 80 and over ,Heart Valve Prosthesis Implantation ,Stenosis ,Multidisciplinary ,Mortality rate ,Heart ,Prognosis ,Survival Rate ,medicine.anatomical_structure ,Cardiovascular Diseases ,Aortic Valve ,Medicine ,Female ,Anatomy ,medicine.symptom ,Aortic Valve Replacement ,Research Article ,medicine.medical_specialty ,Death Rates ,Endocrine Disorders ,Science ,Cardiology ,Surgical and Invasive Medical Procedures ,Asymptomatic ,Signs and Symptoms ,Population Metrics ,Diabetes Mellitus ,medicine ,Humans ,Adverse effect ,Aged ,Retrospective Studies ,Population Biology ,business.industry ,Biology and Life Sciences ,Retrospective cohort study ,Aortic Valve Stenosis ,medicine.disease ,Surgery ,Case-Control Studies ,Medical Risk Factors ,Metabolic Disorders ,Asymptomatic Diseases ,Cardiovascular Anatomy ,Clinical Medicine ,business - Abstract
Background and aim of the study Patients with asymptomatic, severe aortic stenosis are presumed to have a benign prognosis. In this retrospective cohort study, we examined the natural history of contemporary patients advised against aortic valve replacement due to a perceived lack of symptoms. Materials and methods We reviewed the medical records of every patient given the ICD-10-code for aortic stenosis (I35.0) at Oslo University Hospital, Rikshospitalet, between Dec 1st, 2002 and Dec 31st, 2016. Patients who were evaluated by the heart team due to severe aortic stenosis were categorized by treatment strategy. We recorded baseline data, adverse events and survival for the patients characterized as asymptomatic and for 100 age and gender matched patients scheduled for aortic valve replacement. Results Of 2341 patients who were evaluated for aortic valve replacement due to severe aortic stenosis, 114 patients received conservative treatment due to a lack of symptoms. Asymptomatic patients had higher mortality than patients who had aortic valve replacement, log-rank p Conclusions In this retrospective study, asymptomatic patients with severe aortic stenosis who were advised against surgery had significantly higher mortality than patients who had aortic valve replacement.
- Published
- 2021