Aortic stenosis natural history, complications and prognosis: Difference between revisions

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Revision as of 19:36, 25 July 2011

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editors-In-Chief: Claudia P. Hochberg, M.D. [2]; Abdul-Rahman Arabi, M.D. [3]; Keri Shafer, M.D. [4]

Overview

As with any surgical intervention, surgical therapies for aortic stenosis carry risks and potential for complication. These complications commonly include vascular issues such as vascular complications and mitral valve injury.

Complications

Complications stemming from aortic stenosis surgical therapies primarily involve vascular complications.

The most common methodology is a perclose or angioseal closure and is the most preferable for this tenuous patient population. This particular closure method calls for a mandatory attention to the meticulous access technique. An antegrade approach may be a viable method in some patient populations. An example of such would be the venuous access with transseptal approach. This particular procedure can be done in a select population of patients. Many patients are unable to tolerate this approach as the hemodynamic effects of mitral valve incompetence is a stiff wire as it is placed across the mitral valve. Mitral valve injury can occur as a result of such rigidity.

Prognosis

30% reduction in gradient is expected as the immediate result of surgical intervention. Patient survival after repeat BAV is higher than that of untreated patients.

References

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@@ Line 3: / Line 3: @@
 '''Associate Editors-In-Chief:''' Claudia P. Hochberg, M.D. [mailto:chochber@bidmc.harvard.edu]; [[User:Abdarabi|Abdul-Rahman Arabi, M.D.]] [mailto:abdarabi@yahoo.com]; [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu]
+==Overview==
+As with any surgical intervention, surgical therapies for aortic stenosis carry risks and potential for complication. These complications commonly include vascular issues such as vascular complications and mitral valve injury.
 ==Complications==
-*Vascular complications are most common thus suture (Perclose) or Angioseal closure after the procedure in this tenuous patient population is preferable
+Complications stemming from aortic stenosis surgical therapies primarily involve vascular complications.
-*It follows that attention to meticulous access technique is mandatory
-*Antegrade approach ie venous access with transseptal approach can be done in select patients, however, hemodynamic effects of mitral valve incompetence as a stiff wire is placed across the mitral valve are often poorly tolerated; mitral valve injury has been reported in this approach
+The most common methodology is a perclose or angioseal closure and is the most preferable for this tenuous patient population. This particular closure method calls for a mandatory attention to the meticulous access technique. An antegrade approach may be a viable method in some patient populations. An example of such would be the venuous access with transseptal approach. This particular procedure can be done in a select population of patients. Many patients are unable to tolerate this approach as the hemodynamic effects of mitral valve incompetence is a stiff wire as it is placed across the mitral valve. Mitral valve injury can occur as a result of such rigidity.
 ==Prognosis==
-% reduction in gradient is expected as the immediate result Patient survival after repeat BAV is higher than that of untreated patients.
+% reduction in gradient is expected as the immediate result of surgical intervention. Patient survival after repeat BAV is higher than that of untreated patients.
 ==References==
 {{reflist|2}}
-{{Circulatory system pathology}}
-{{Congenital malformations and deformations of circulatory system}}
 [[Category:DiseaseState]]
 [[Category:Signs and symptoms]]
@@ Line 24: / Line 24: @@
 [[Category:Cardiology]]
 [[Category:Congenital heart disease]]
+[[Category:Mature chapter]]
 {{WH}}
 {{WS}}