Early Surgery vs. Surgery After Watchful Waiting for Asymptomatic Severe Aortic Stenosis

Circulation Journal : Official Journal of the Japanese Circulation Society
Makoto MiyakeCURRENT AS Registry Investigators

Abstract

There is no large-scale study comparing postoperative mortality after aortic valve replacement (AVR) for asymptomatic severe aortic stenosis (AS) between initial treatment with AVR vs. eventual AVR after conservative management. Methods and Results: We analyzed data from a multicenter registry enrolling 3,815 consecutive patients with severe AS. Of 1,808 asymptomatic patients, 286 patients initially underwent AVR (initial AVR group), and 377 patients were initially managed conservatively and eventually underwent AVR (AVR after watchful waiting group). Mortality after AVR was compared between the 2 groups. Subgroup analysis according to peak aortic jet velocity (Vmax) at diagnosis was also conducted. There was no significant difference between the 2 groups in 5-year overall survival (OS; 86.0% vs. 84.1%, P=0.34) or cardiovascular death-free survival (DFS; 91.3% vs. 91.1%, P=0.61), but on subgroup analysis of patients with Vmax ≥4.5 m/s at diagnosis, the initial AVR group was superior to the AVR after watchful waiting group in both 5-year OS (88.4% vs. 70.6%, P=0.003) and cardiovascular DFS (91.9% vs. 81.7%, P=0.023). Asymptomatic severe AS patients who underwent AVR after watchful waiting had a postoperative survival rate simila...Continue Reading

References

Apr 1, 1990·Journal of the American College of Cardiology·P A PellikkaA J Tajik
Apr 1, 1988·European Heart Journal·D Horstkotte, F Loogen
Jan 1, 1973·British Heart Journal·S FrankJ Ross
Jul 1, 1968·Circulation·J Ross, E Braunwald
Aug 31, 2000·The New England Journal of Medicine·R RosenhekH Baumgartner
Nov 28, 2006·The Annals of Thoracic Surgery·Padmini VaradarajanRamdas G Pai
Dec 23, 2009·Circulation·Raphael RosenhekGerald Maurer
Aug 28, 2012·European Heart Journal·UNKNOWN Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC)Marian Zembala
Aug 21, 2014·The New England Journal of Medicine·Catherine M Otto, Bernard Prendergast
Oct 20, 2015·Journal of the American College of Cardiology·Tomohiko TaniguchiUNKNOWN CURRENT AS Registry Investigators
Apr 7, 2016·Journal of the American College of Cardiology·Philippe GénéreuxMartin B Leon

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Citations

Nov 23, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Soichiro TamuraMinoru Yoshiyama
Aug 7, 2019·European Heart Journal. Quality of Care & Clinical Outcomes·Eri Minamino-MutaTakeshi Kimura
Feb 8, 2021·Hellenic Journal of Cardiology : HJC = Hellēnikē Kardiologikē Epitheōrēsē·Changmin WeiChunshan Zhao
Nov 10, 2020·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Choon-Sik JhunGerson Rosenberg

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