Why the study?
Patients with high-gradient severe aortic stenosis and LV dysfunction are at high risk of death, but guidelines do not define the optimal timing for aortic valve replacement.
Does prompt isolated aortic valve replacement reduce mortality in patients with high-gradient severe aortic stenosis and LVEF ≤35% compared to those with LVEF >35%?
Does prompt isolated aortic valve replacement reduce mortality in patients with high-gradient severe aortic stenosis and LVEF ≤35% compared to those with LVEF >35%?
Answers are grounded in this paper and cite their sources.
Patients with high-gradient severe aortic stenosis and LVEF ≤35% face a very high and premature risk of death while waiting for intervention, indicating that AVR should be performed promptly after a Heart Team decision.
BACKGROUND: Patients with high-gradient (HG) severe aortic stenosis (AS) and left ventricular (LV) dysfunction are at high risk of death. The optimal timing for aortic valve replacement (AVR) is not defined by guidelines. The objective was to define the optimal timing to perform isolated AVR in patients with HG-AS and severe LV dysfunction. METHODS: = 205) LVEF ≤35%. All death in HG-AS patients with a severe LV dysfunction occurred within the first month. Postoperative mortality was low (1.3%), irrespective of LVEF. CONCLUSIONS: AVR should be performed promptly after Heart Team decision in patients with HG severe AS and LVEF ≤35% because of a very high and premature risk of death while waiting for intervention.
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Koutsoukis et al. (2020) studied this question.
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