Uncategorized

Hear leading experts discuss how to adopt a comprehensive and patient-centred management approach in the care of severe aortic stenosis (sAS) patients

• With an average survival rate of 50% at two years and 20% at five years, the timely and accurate diagnosis of AS is essential¹
  
  
• An integrated and stepwise approach to echocardiography assessment of AS is a key diagnostic tool for confirming the diagnosis and severity of AS²
  
  
• However, it is important to understand the limitations of echocardiography to avoid the underestimation of AS severity^3,5

• Roughly 1/3 of patients with severe aortic stenosis (sAS) are asymptomatic and once symptoms develop their average survival declines^1,2
  
  
• Symptom detection is difficult with many patients attributing them to other factors^3,4. Exercise testing is important for unmasking symptoms in patients with asymptomatic sAS⁵
  
  
• Treatment is recommended in patients with asymptomatic severe aortic stenosis in the presence of one or more of these factors: adverse prognostic factors^*, LVEF<50%, positive exercise test† or symptom development⁶

The new 2021 ESC/EACTS VHD guidelines recommend that all* symptomatic patients with severe aortic stenosis (sAS) are referred to the Heart Team for a treatment evaluation. The Heart Team will assess multiple patient factors, including their age, their values and preferences, when making the final decision between TAVI and SAVR.¹

* With treatment indication. ¹

In this recorded webinar hear from leading cardiologist Dr. Shrilla Banerjee on:

• What sort of service does she want for her patients
• Which patients should be referred
• The ideal patient pathway
• Barriers to the adoption of TAVI
• A new tool for the referral process that includes assessment of frailty

Supported by proven results from PARTNER 3,¹ low-risk patients with sAS now have the opportunity for TAVI. As these patients are usually younger and healthier than those in higher risk categories,^1-6 further considerations for this group include valve durability and valve-in-valve (ViV) procedures that support their longer-term management.

The characterisation of aortic stenosis (AS) severity remains an ongoing challenge in clinical practice. Patients with discordant echocardiographic indices are commonly described in reports as having less than sAS despite meeting the criteria for sAS. Understanding the limitations of echocardiographic and adopting a step-by-step integrative approach to confirm AS severity can help meet the challenge.^1-3

Patients often reduce physical activity to avoid symptoms, making it challenging to correctly identify when symptoms do develop.^1-4The added burden of COVID-19 risks exacerbating this through the risk of reduced hospital appointments and limited physical activity during lockdowns.^5,6