Estenose Aortica: A força vem do ventrículo






New perspectives in the treatment of low-flow AS

The improvement in the clinical outcome of patients with low-flow AS will, in large part, come from a better assessment of stenosis severity and a better risk stratification as described above. Furthermore, the optimization of the operative strategies should contribute to reduce the operative mortality in the subset of patients treated surgically. To this effect, several studies recently demonstrated a strong interaction between prosthesis-patient mismatch and depressed LV function with regard to occurrence of heart failure as well as to early and late mortality after AVR. As outlined above, these findings are consistent with the fact that an increased hemodynamic burden is less well tolerated by a poorly functioning ventricle than by a normal ventricle. In light of these recent data, every effort should be made to avoid prosthesis-patient mismatch in the patients with low-flow AS. The clinical implications of these findings are important given that prosthesis-patient mismatch is frequent (20% to 30%) after AVR and, as opposed to other risk factors, it can largely be avoided or its severity can be reduced with the use of a prospective strategy at the time of operation.


Fiquei em dúvida se fui eu que não entendi o texto ou foi o Phillipe Piparot.

Mas como ele é canadense, deve estar certo!


Philippe Pibarot , Laval Hospital Research Center, 2725 Chemin Sainte-Foy, Quebec, Canada

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