HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Hagen D. Schulte Reiner Koerfer Dieter Horstkotte Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Piper, C. Articles by Horstkotte, D. Search for Related Content PubMed PubMed Citation Articles by Piper, C. Articles by Horstkotte, D. Related Collections Valve disease

Ann Thorac Surg 2003;76:676-680
© 2003 The Society of Thoracic Surgeons

---

Original article: cardiovascular

Can progression of valvar aortic stenosis be predicted accurately?

^a Department of Cardiology, Heart Center North Rhine-Westphalia, Ruhr University of Bochum, Bad Oeynhausen, Germany
^d Department of Thoracic and Cardiovascular Surgery, Heart Center North Rhine-Westphalia, Ruhr University of Bochum, Bad Oeynhausen, Germany
^b Institute for Medical Outcome Research, Lörrach, Germany
^c Department of Thoracic and Cardiovascular Surgery, Heinrich-Heine University, Düsseldorf, Germany

Accepted for publication March 20, 2003.

^* Address reprint requests to Dr Piper, Department of Cardiology, Heart Center North Rhine-Westphalia, Ruhr University of Bochum, Georgstr. 11, D-32545 Bad Oeynhausen, Germany
e-mail: cpiper{at}hdz-nrw.de

BACKGROUND: It was the aim of the present study to elaborate criteria for the assessment of rapid hemodynamic progression of valvar aortic stenosis. These criteria are of special importance when cardiac surgery is indicated for other reasons but the established criteria for aortic valve replacement are not yet fulfilled. Such aspects of therapeutic planing were mostly disregarded in the past so that patients had to undergo cardiac reoperation within a few years.

METHODS: Hemodynamic, echocardiographic, and clinical data of 169 men and 88 women with aortic stenosis, aged 55.2 ± 15.7 years at their first and 63.4 ± 15.6 years at their second cardiac catheterization, were analyzed.

RESULTS: The progression rate of aortic valve obstruction was found to be dependent on the degree of valvar calcification ([VC] scoring 0 to III) and to be exponentially correlated with the aortic valve opening area (AVA) at initial catheterization. Neither age nor sex of the patient nor etiology of the valvar obstruction significantly influence the progression of aortic stenosis. If AVA decreases below 0.75 cm² with a present degree of VC = 0, or AVA of 0.8 with VC of I, AVA of 0.9 with VC of II, or AVA of 1.0 with VC of III, it is probable that aortic stenosis will have to be operated upon in the following years.

CONCLUSIONS: The present data indicate that for clinical purposes and planning of valvar surgery the progression of asymptomatic aortic stenosis can be sufficiently predicted by the present aortic valve opening area and the degree of valvar calcification.

This article has been cited by other articles:

				F. Liu, C. A. Coursey, C. Grahame-Clarke, R. R. Sciacca, A. Rozenshtein, S. Homma, and J. H. M. Austin Aortic Valve Calcification as an Incidental Finding at CT of the Elderly: Severity and Location as Predictors of Aortic Stenosis Am. J. Roentgenol., February 1, 2006; 186(2): 342 - 349. [Abstract] [Full Text] [PDF]

				S. F. Aranki, M. Nathan, P. Shekar, G. Couper, R. Rizzo, and L. H. Cohn Hypothermic Circulatory Arrest Enables Aortic Valve Replacement in Patients With Unclampable Aorta Ann. Thorac. Surg., November 1, 2005; 80(5): 1679 - 1687. [Abstract] [Full Text] [PDF]