Epidemiology

• Disease Associations
  • Sinus of Valsalva Aneurysm (see Sinus of Valsalva Aneurysm)

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Etiology

• xxx

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Clinical

Cardiac Manifestations

• xxxxxxx
• xxxxxxx
• Systolic Murmur (see Heart Murmurs)
• Syncope (see Syncope)

Hematologic Manifestations

• Acquired Von Willebrand Disease (see Von Willebrand Disease): due to excessive shear across stenotic aortic valve, with increased suscpetibility of large von Willebrand factor multimers to serum protease degradation
  • Produces an acquired type 2 von Willebrand disease

Other Manifestations

• Heyde’s Syndrome: constellation of aortic stenosis + gastrointestinal angiodysplasia
• xxxxxxx

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Treatment

Management of Congestive Heart Failure (CHF) (see Congestive Heart Failure)

• Standard Treatment

Open Aortic Valve Replacement (AVR) (see xxxxx)

Functional Benefits

• Results in Resolution of Acquired Von Willebrand Disease

Transcatheter Aortic Valve Replacement (TAVR) (see Transcatheter Aortic Valve Replacement)

Indications

• xxx

Functional Benefits

• Study of Functional Benefits of TAVR [Ann Intern Med. 2014;160(4):243-254-254] [MEDLINE]
  • Main Findings: provides clinically important benefits in physical function and disease-specific measures of quality of life, but modest benefits in psychological and general health measures

Complications

• Atrioventricular Heart Blocks
  • Epidemiology: approximately 33% of patients require a permanent pacemaker within 30 days of the procedure
    • There may be a higher rate of atrioventricular block with self-expanding implanted aortic valves, as compared to balloon expandable versions
  • Predictors of Post-TAVR Atrioventricular Block
    • Pre-existing cardiac conduction disturbance
    • Narrow left ventricular outflow tract
    • Increased severity of mitral annular calcification appear to be predictors of this complication
  • Clinical
    • First Degree Atrioventricular Block (First Degree Heart Block) (see First Degree Atrioventricular Block)
    • Second Degree Atrioventricular Block-Mobitz Type I (Wenckebach) (see Second Degree Atrioventricular Block-Mobitz Type I)
    • Second Degree Atrioventricular Block-Mobitz Type II (see Second Degree Atrioventricular Block-Mobitz Type II)
    • Third Degree Atrioventricular Block (Third Degree Heart Block, Complete Heart Block) (see Third Degree Atrioventricular Block)

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References

• Functional Status and Quality of Life After Transcatheter Aortic Valve Replacement: A Systematic Review. Ann Intern Med. 2014;160(4):243-254-254. doi:10.7326/M13-1316 [MEDLINE]
• xxx

Treatment

• Causes of Death Following Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2015 Sep 21;4(9):e002096. doi: 10.1161/JAHA.115.002096. [MEDLINE]
• Aortic Valve Implantation Versus Surgical Aortic Valve Replacement: A Systematic Review and Meta-analysis. Ann Intern Med. Published online 7 June 2016 doi:10.7326/M16-0060 [MEDLINE]