Echocardiographic evaluation of cardiac function response to removal of aortic stenosis: Surgical and trans-catheter aortic valve implantation (TAVI)
Abstract
Aortic stenosis (AS) is the commonest valve disease in the
West, with a prevalence varying between 0.02% in adults
under 44 years and 3-9% in those over 80 years of age 1, 2. The
disease may remain “silent” and hence unnoticed for years,
particularly in the elderly with naturally limited exercise. With the
development of symptoms, patients may carry a mortality of
36-52%, 52-80% and 80-90% at 3, 5 and 10 years, respectively
if left untreated, with a potential high risk of sudden death 3.
Surgical aortic valve replacement (SAVR) used to be the only
effective treatment for severe AS, being the second indication
for open heart surgery after coronary artery bypass grafting
(CABG) 4. Trans-catheter aortic valve implantation (TAVI) is a
recently developed procedure which aims at non-surgical AVR
in patients with severe, symptomatic and calcified AS who
are at high surgical risk because of either poor left ventricular
(LV) function, ejection fraction (EF) <50%, or other significant
co-morbidities e.g. age >80 years, previous CABG surgery and/
or aorta or other heart valve surgery, impaired kidney function,
chronic obstructive pulmonary disease (COPD) or pulmonary
hypertension 5. Currently, this technique is not recommended
in bicuspid AS patients due to the risk of incomplete and
suboptimal deployment of the aortic prosthesis [6]. TAVI
avoids open heart surgery and hence is likely to protect
myocardial function. The purpose of this paper is to review the
echocardiographic evaluation of LV, right ventricular (RV), and
left atrial (LA) function response to SAVR and TAVI for AS.
DOI: https://doi.org/10.17987/icfj.v1i1.9
Copyright (c) 2015 Ying Zhao, Yi-hua He

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.