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Management of aorti...
Management of aortic stenosis : A systematic review of clinical practice guidelines and recommendations
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- Khanji, Mohammed Y. (author)
- Queen Mary University,Barts Health NHS Trust
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- Ricci, Fabrizio (author)
- Lund University,Lunds universitet,Kardiovaskulär forskning - hypertoni,Forskargrupper vid Lunds universitet,Cardiovascular Research - Hypertension,Lund University Research Groups,University of Milano-Bicocca,University G.d'Annunzio of Chieti-Pescara
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- Galusko, Victor (author)
- King's College Hospital
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- Sekar, Baskar (author)
- Swansea Bay University Health Board
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- Chahal, C. Anwar A. (author)
- Barts Health NHS Trust,University of Pennsylvania,Mayo Clinic Minnesota
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- Ceriello, Laura (author)
- University G.d'Annunzio of Chieti-Pescara
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- Gallina, Sabina (author)
- University G.d'Annunzio of Chieti-Pescara
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- Kennon, Simon (author)
- Barts Health NHS Trust
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- Awad, Wael I. (author)
- Barts Health NHS Trust
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- Ionescu, Adrian (author)
- Swansea Bay University Health Board
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(creator_code:org_t)
- 2021-03-05
- 2021
- English 14 s.
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In: European Heart Journal - Quality of Care and Clinical Outcomes. - : Oxford University Press (OUP). - 2058-5225 .- 2058-1742. ; 7:4, s. 340-353
- Related links:
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http://dx.doi.org/10...
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https://www.ncbi.nlm...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Multiple guidelines exist for the management of aortic stenosis (AS). We systematically reviewed current guidelines and recommendations, developed by national or international medical organizations, on management of AS to aid clinical decision-making. Publications in MEDLINE and EMBASE between 1 June 2010 and 15 January 2021 were identified. Additionally, the International Guideline Library, National Guideline Clearinghouse, National Library for Health Guidelines Finder, Canadian Medical Association Clinical Practice Guidelines Infobase, and websites of relevant organizations were searched. Two reviewers independently screened titles and abstracts. Two reviewers assessed rigour of guideline development and extracted the recommendations. Of the seven guidelines and recommendations retrieved, five showed considerable rigour of development. Those rigourously developed, agreed on the definition of severe AS and diverse haemodynamic phenotypes, indications and contraindications for intervention in symptomatic severe AS, surveillance intervals in asymptomatic severe AS, and the importance of multidisciplinary teams (MDTs) and shared decision-making. Discrepancies exist in age and surgical risk cut-offs for recommending surgical aortic valve replacement (SAVR) vs. transcatheter aortic valve implantation (TAVI), the use of biomarkers and complementary multimodality imaging for decision-making in asymptomatic patients and surveillance intervals for non-severe AS. Contemporary guidelines for AS management agree on the importance of MDT involvement and shared decision-making for individualized treatment and unanimously indicate valve replacement in severe, symptomatic AS. Discrepancies exist in thresholds for age and procedural risk used in choosing between SAVR and TAVI, role of biomarkers and complementary imaging modalities to define AS severity and risk of progression in asymptomatic patients.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Aortic stenosis
- Aortic valve replacement
- Guidelines recommendations
- TAVI
- Transcatheter aortic valve implantation
Publication and Content Type
- for (subject category)
- ref (subject category)
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- By the author/editor
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Khanji, Mohammed ...
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Ricci, Fabrizio
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Galusko, Victor
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Sekar, Baskar
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Chahal, C. Anwar ...
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Ceriello, Laura
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show more...
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Gallina, Sabina
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Kennon, Simon
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Awad, Wael I.
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Ionescu, Adrian
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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European Heart J ...
- By the university
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Lund University