Calcific aortic valve stenosis: potentials and complications of surgical treatment

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Abstract

Aim. The study aim is to discuss different approaches to the selection of a method of surgical correction of pronounced aortic stenosis (AS). Indications, contraindications, advantages and probable complications of transcatheter aortic valve implantation (TAVI) are considered. A description of a clinical case is given, and probable causes of unfavorable outcomes are discussed.

AS is the most common valvular disease, and its frequency increases significantly with age. It is one of the leading indications for heart surgery. A peculiarity of the clinical presentation of AS is a long asymptomatic period that varies from patient to patient. With the appearance of the first clinical manifestations, the prognosis of the disease sharply worsens. For a long time, surgical replacement of the aortic valve remained «the gold standard» of treatment of patients with symptomatic AS. An increase in the number of elderly patients and those in old age with many comorbid diseases who have received cardiopulmonary bypass is linked with an increased risk of postoperative complications, which are became a determining factor for the development of alternative methods of surgical correction of aortic valve pathology.

Conclusion. At present, TAVI has considerable advantages over surgical replacement; is a method of choice for elderly and inoperable patients as well as patients at high, intermediate, and low risk from surgery; and requires a multidisciplinary approach.

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About the authors

Elena A. Smirnova

Ryazan State Medical University; Regional Clinical Cardiology Dispensary

Author for correspondence.
Email: smirnova-ea@inbox.ru
ORCID iD: 0000-0003-0334-6237
SPIN-code: 6503-8046
ResearcherId: Y-1235-2018

MD, PhD, Associate Professor of the Department of Hospital Therapy with the Course of Medical and Social Expertise

Russian Federation, Ryazan, Russia

Alena I. Terekhina

Ryazan State Medical University

Email: alenaterehina@mail.ru
ORCID iD: 0000-0002-2087-1458
SPIN-code: 6812-1280
ResearcherId: AAN-9005-2020

6th-year Student of the General Medicine Faculty

Russian Federation, Ryazan, Russia

Sergey P. Filonenko

Ryazan State Medical University

Email: dr.filonenko@gmail.com
ORCID iD: 0000-0001-6658-2072
SPIN-code: 1106-0648
ResearcherId: AAO-9466-2020

MD, PhD, Associate Professor of the Department of Hospital Therapy with the Course of Medical and Social Expertise

Russian Federation, Ryazan, Russia

Elena N. Muranchik

Ryazan Regional Clinical Cardiological Dispensary

Email: enmuranchik@yandex.ru
ORCID iD: 0000-0001-6375-6073
SPIN-code: 8266-2535
ResearcherId: ААО-5677-2020

Cardiologist

Russian Federation, Ryazan, Russia

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Copyright (c) 2021 Smirnova E., Terekhina A., Filonenko S., Muranchik E.



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