Mechanical Intervention for Aortic Valve Stenosis in Patients With Heart Failure and Reduced Ejection Fraction

Johannes Steiner, Josep Rodés-Cabau, David Holmes, Martin M. LeWinter, Harold L. Dauerman

Research output: Contribution to journalReview article

5 Scopus citations

Abstract

The risk and benefit of mechanical interventions in valvular heart disease have been primarily described among patients with normal ejection fraction. The advent of nonsurgical mechanical interventions for aortic stenosis (transcatheter aortic valve replacement) may alter the risk-benefit ratio for patients who would otherwise be at increased risk for valve surgery. This review describes the epidemiology and pathophysiology of aortic stenosis with heart failure and reduced ejection fraction and summarizes the current registry and clinical trial data applicable to this frequently encountered high-risk group. It concludes with discussion of ongoing trials, new approaches, emerging indications, and a potential clinical algorithm incorporating optimal mechanical intervention for patients with aortic stenosis and concomitant reduced ejection fraction.

Original languageEnglish (US)
Pages (from-to)3026-3041
Number of pages16
JournalJournal of the American College of Cardiology
Volume70
Issue number24
DOIs
StatePublished - Dec 19 2017
Externally publishedYes

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Keywords

  • aortic stenosis
  • congestive heart failure
  • transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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