Comorbidities should not act as barriers to referring appropriate patients with symptomatic severe aortic stenosis (sSAS) to a Heart Valve Team1
Managing patients with sSAS who have preexisting conditions can be challenging.2,3
Comorbidities among patients with sSAS are common
of patients had 2 or more chronic conditions before being diagnosed with sSAS1
have 4 or more chronic conditions1
The most common comorbidities include heart failure, hypertension, chronic kidney disease (CKD), atrial fibrillation, and chronic obstructive pulmonary disease (COPD)1
Peer Perspectives:
Who should be referred for a Heart Valve Team evaluation
“The sooner [patients] are treated, the sooner we can give them back their quality of life.”
-
Antonio H. Frangieh, MD Interventional Cardiologist
When you refer patients to a Heart Valve Team, you may mitigate a crucial threat to your patients’ overall health and their preexisting conditions could potentially be improved.4-8
TAVR showed improvement in QoL regardless of severity or definition in patients with moderate-to-severe CKD4,5
And the majority of patients with heart failure who underwent TAVR experienced an improvement in NYHA status, symptoms, hospitalization, and in-hospital mortality9
TAVR HAS BECOME THE PREFERRED PROCEDURE FOR sSAS10
References:1.Feldman DR, Romashko MD, Koethe B, et al. Comorbidity burden and adverse outcomes after transcatheter aortic valve replacement. J Am Heart Assoc. 2021;10(10):e018978. 2.Lindman BR, Clavel MA, Mathieu P, et al. Calcific aortic stenosis. Nat Rev Dis Primers. 2016;2:16006. Published 2016 Mar 3.3.Flannery L, Etiwy M, Camacho A, et al. Patient- and process-related contributors to the underuse of aortic valve Replacement and subsequent mortality in ambulatory patients with severe aortic stenosis. J Am Heart Assoc. 2022;11(11):e025065.4.Bohbot Y, Candellier A, Diouf M, et al. Severe aortic stenosis and chronic kidney disease: outcomes and impact of aortic valve replacement. J Am Heart Assoc. 2020;9(19):e017190.5.Cubeddu RJ, Asher CR, Lowry AM, et al. Impact of transcatheter aortic valve replacement on severity of chronic kidney disease. J Am Coll Cardiol. 2020;76(12):1410-1421.6.Badiani S, Bhattacharyya S, Aziminia N, et al. Moderate aortic stenosis: what is it and when should we intervene? Interv Cardiol. 2021;16:e09.7.Gilmore RC, Thourani VH, Jensen HA, et al. Transcatheter aortic valve replacement results in improvement of pulmonary function in patients with severe aortic stenosis. Ann Thorac Surg. 2015;100(6):2167-2173.8.Moretti M, Fabris E, Morosin M, et al. Prognostic significance of atrial fibrillation and severity of symptoms of heart failure in patients with low gradient aortic stenosis and preserved left ventricular ejection fraction. Am J Cardiol. 2014;114(11):1722-1728.9.Mack MJ, Leon MB, Thourani VH, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med. 2019;380(18):1695-1705.10.Madhavan MV, Kodali SK, Thourani VH, et al. Outcomes of SAPIEN 3 transcatheter aortic valve replacement compared with surgical valve replacement in intermediate-risk patients. J Am Coll Cardiol. 2023;82(2):109-123.
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