Interní Med. 2007; 9(2): 88-90

The update on treatment of aortic stenosis

prof. MUDr. Roman Čerbák CSc¹, MUDr. Kateřina Linhartová^3,2

¹ Centrum kardiovaskulární a transplantační chirurgie v Brně

² Kardiovaskulární centrum FN Motol, Praha

³ I. Interní klinika, kardiologické oddělení, FN Plzeň

Aortic stenosis is after hypertension and ischemic heart disease the third most frequent cardiovascular disease. It is also the most frequently operated valve defect. Statins and inhibitors of renin-angiotensin system are recommended for medical therapy. In spite of quite frequent reports about their beneficial effect on progression of the disease, at present there is no evidence for this treatment. Prospective randomized clinical trials that should ascertain the indication of this treatment are being planned. Surgical replacement of the valve remains the only effective way how to treat hemodynamically significant aortic valve defect (AVA< 0.5 cm2/m2 and a mean gradient LV/Ao > 50 mm Hg). However new opinions occur even here. While in the past the surgery was delayed until symptoms or evidence of left ventricle dysfunction develops, nowadays there are emerging voices for earlier operation even of asymptomatic patients with good function of left ventricle. A new technology is a percutaneous catheterization implantation of aortic valve. This method has so far been used rarely; in future it could bring hope to patients with aortic stenosis with contraindications for a surgery.

Keywords: Key words: aortic stenosis, medical therapy, statins, ACE inhibitors, indication for surgery, cardiac surgery, interventional catheterization therapy.

Published: March 1, 2007  Show citation