Surgery for asymptomatic degenerative aortic and mitral valve disease.
Degenerative valvular heart disease, the most common form of valve disease in the Western world, can lead to aortic stenosis (AS) or mitral regurgitation (MR). In current guidelines for the management of patients with degenerative valvular disease, surgical intervention is recommended at the onset of symptoms or in the presence of left ventricular systolic impairment. Whether surgery is appropriate for asymptomatic patients remains a controversial issue. We argue the case for early pre-emptive intervention in selected, asymptomatic individuals with AS or MR, drawing on contemporary perioperative data, predictors of disease progression, and studies of the natural history of degenerative valvular heart disease.
Zena and Michael A. Wiener Cardiovascular Institute, Marie-Jose and Henry R. Kravis Cardiovascular Health Center, The Mount Sinai School of Medicine, New York, NY 10029, USA. prashant.vaishnava@mountsinai.org
Prashant
P
Vaishnava
Valentin
V
Fuster
Martin
M
Goldman
Robert O
RO
Bonow
D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D018450:Disease Progression; D006801:Humans; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D018570:Risk Assessment; D013997:Time Factors
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