IMR Press / RCM / Volume 25 / Issue 3 / DOI: 10.31083/j.rcm2503099
Open Access Review
Severe Aortic Stenosis Associated with Other Valve Diseases: Open Surgery or Percutaneous Treatment?
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1 Cardiology Department, Hospital Universitari Doctor Josep Trueta, 17007 Girona, Spain
2 Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
3 Department of Medical Sciences, Universitat de Girona, 17003 Girona, Spain
4 Dirección Territorial de Radiología y Medicina Nuclear de Girona. IDI. IDIBGI, 17007 Girona, Spain
*Correspondence: moral.sergio@yahoo.es (Sergio Moral)
Rev. Cardiovasc. Med. 2024, 25(3), 99; https://doi.org/10.31083/j.rcm2503099
Submitted: 6 November 2023 | Revised: 25 November 2023 | Accepted: 7 December 2023 | Published: 8 March 2024
(This article belongs to the Special Issue New Perspectives of Valvulopathy)
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Treatment decisions in the context of severe aortic stenosis (AS) associated with other valvular heart diseases (VHDs) have become a major challenge in recent years. Transcatheter aortic valve replacement (TAVR) in AS has increased significantly in younger patients with lower surgical risk, which has complicated the choice of the best treatment in cases of other associated valvulopathies. The most frequently associated lesions in this clinical scenario are mitral regurgitation (MR), mitral stenosis, and tricuspid regurgitation (TR). Furthermore, it should be noted that different percutaneous techniques are now available to accommodate any associated valvulopathies, which has considerably broadened the range of therapeutic options. The management of AS treated in isolation, especially by TAVR, has also shown that many cases of significant MR or TR are substantially reduced without any intervention. However, although some parameters have been described as potential risk factors in predicting the poor outcome of untreated VHDs, which cases will progress in a clinically more aggressive way remains uncertain. This review aimed to evaluate the most recent publications to provide the pathophysiology and prognosis of severe AS associated with other significant VHDs and to evaluate the best invasive therapeutic approach depending on the associated valvular disease.

Keywords
aortic stenosis
valvular heart diseases
transcatheter aortic valve replacement
mitral regurgitation
tricuspid regurgitation
mitral stenosis
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