Prevalence and clinical outcome of isolated aortic stenosis: A single-center experience

Abstract

Background: There is a paucity of data regarding the prevalence and clinical outcomes of patients with isolated aortic stenosis (AS) in Saudi Arabia. Aim: Study investigates the prevalence AS and the effects of different treatment modalities on patients’ symptoms. Materials and Methods: This retrospective cohort study included patients diagnosed with isolated trileaflet AS between October 2015 and October 2018. Of 2300 patients who presented to our institution with valvular heart disease, 107 (4.7%) had isolated trileaflet AS. Results: The patients’ median age was 76 years (range 67–82). Dyspnea was the most common presenting symptom (n = This 86, 80.4%). The mean aortic valve area was 0.995 ± 0.35 mm2. Six patients (5.6%) had mild, 44 (41.1%) had moderate, and 57 (53.3%) had severe AS. Twenty-three patients with moderate/severe AS underwent surgery (22.8%), 24 patients underwent transcatheter valve intervention (TAVI) (23.8%), and 54 patients received medical treatment (53.5%). Marked symptom improvement was observed in patients who had surgery (n = 20, 86.96%), TAVI (n = 18, 75%), and medical treatment (n = 11, 18.33%) (P < 0.001). The factors affecting symptom improvement were surgery (odds ratio [OR] 21.97 [95% confidence interval (CI): 4.79–100.7]; P < 0.001) and TAVI (OR 9.27 [95% CI: 2.38–36.08]; P = 0.001). Conclusions: A prevalence of 4.7% was found for isolated trileaflet AS in patients who presented to our institution with valvular heart disease. Symptoms improved in patients who received interventional approaches compared with those who received medical management. Medical management should be strictly reserved for patients who cannot tolerate surgical or transcatheter aortic valve replacement.

Keywords

• aortic stenosis
• aortic valve
• surgical aortic valve replacement
• transcatheter aortic valve intervention