Study: People with aortic stenosis may benefit from earlier valve replacement

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A new study highlights the benefits of earlier valve replacement surgery in people with aortic stenosis. File photo by Kzenon/Shutterstock

People with a form of heart disease called aortic stenosis should undergo valve replacement surgery before symptoms first appear in order to avoid permanent damage, researchers said in an article published Tuesday.

Most patients with aortic stenosis — or a narrowing of the valve that separates the pumping chamber of the heart, the left ventricle, from the aorta, which delivers blood to the rest of the body — are not eligible for surgery until they experience symptoms,.

However, after reviewing data from multiple studies, patients who had surgery earlier, before the appearance of symptoms, were 79% less likely to be hospitalized with heart failure, according to the researchers in an article published Tuesday by the journal Open Heart.

They also had a 55% lower risk for death than patients who had surgery later, the data showed.

“A lot of patients with severe aortic stenosis do not have symptoms and therefore are not eligible for valve replacement according to the current guidelines … [which] suggest a ‘watchful waiting’ approach,” Dr. Vassilios Vassiliou, study co-author, said in a press release.

“We wanted to know if it would be better to perform surgery and replace the valve sooner rather than later,” said Vassiliou, a professor of cardiac medicine at the University of East Anglia in Norwich, England.

Aortic stenosis is one of the most common causes of heart disease and it occurs as a result of a narrowing of the aortic valve opening, according to the American Heart Association.

Once people with aortic stenosis develop symptoms — breathlessness, chest pain or blackouts — they are advised to have valve replacement surgery, the association says.

However, many patients with aortic stenosis do not have symptoms even when they have severe narrowing of the valve, Vassiliou and his colleagues said.

The findings of this analysis are based on a review of data from two clinical trials with a total of 302 participants and eight additional studies with 3,496.

“The timing of aortic valve intervention is crucial,” Vassiliou said.

“By the time the patients develop symptoms, there has likely been irreversible damage to the muscle of the heart [and] this in turn may preclude a worse prognosis and adverse outcomes even after successful intervention,” he said.

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