Interdisciplinary therapeutic strategy in a low-risk patient with aortic stenosis and preserved life expectancy
A 71-year-old low-risk patient with symptomatic severe aortic stenosis and preserved ventricular function presents with progressive dyspnoea and chest pain. With long life expectancy, the choice of treatment demands careful interdisciplinary planning. How would you treat?
Author
- 71-year-old male patient
- Referred for evaluation of progressive dyspnea on exertion (NYHA II-III) and chest pain
Cardiovascular risk factors | Clinical presentation | Lifestyle |
Arterial hypertension | Height: 185 cm | Retired |
Elevated lipids | Weight: 105 kg | Active at home |
Former smoker | BMI: 30.7 kg/m2 |
Case planning: Echo
- p-max / mean: 82 / 42 mmHg
- v-max: 3.9 m/s
- EOA: 0.8 cm2
- LV-EF 64 %, preserved RV function
Case planning: CT
Annulus: 29.6 cm
LVOT: 32.2 cm
Moderate Ca2+, tricuspid
Sinus of Valsalva
LCA: 15.9 mm
RCA: 22.2 mm
Right
Left
LAO 3° - cranial 19°
RAO 14° - caudal 9°
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Disclosure
Dr. Conradi reports the following disclosures:
- Advisory Board Member for Medtronic, Abbott, and JenaValve
- Consultant for Edwards Lifesciences, Boston Scientific, Venus Medtech, MicroPort, MicroInterventions, Neovasc, Pi-Cardia, 4C Medical, and Smartcanula SARL
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