Die asymptomatische Aortenstenose

Zusammenfassung

Patienten mit symptomatischer hochgradiger Aortenstenose (AS) wird der Aortenklappenersatz dringend empfohlen. In asymptomatischer AS ist die klinische Strategie noch kontrovers. Prospektive Studien empfehlen ein abwartendes Vorgehen und Verlaufskontrollen. Vor allem bei älteren und komorbiden Patienten kann die Zuordnung des symptomatischen Status zur Erkrankung schwierig sein. Die robuste Messung des Stenosegrades ist daher notwendig, zumal auch Patienten mit asymptomatischer AS von frühem Klappenersatz profitieren. Dieser Übersichtsartikel stellt relevante klinische Studien und Richtlinien zum Management von Patienten mit asymptomatischer AS dar.

Abstract

In patients with symptomatic severe aortic stenosis (AS) therapeutic decision is straightforward and aortic valve replacement is strongly recommended. In asymptomatic AS patients clinical strategy is controversial and challenging. Prospective studies suggest a watchful waiting approach in the majority of patients with regular follow-up exams. Defining symptomatic status related to the disease can be particularly difficult in the elderly and patients with comorbidities. A robust measurement of AS severity is mandatory in this context. Nevertheless some patients with asymptomatic AS benefit from early valve replacement and reliable risk stratification for identification of high-risk patients is of importance. This review article will outline relevant clinical studies and guidelines on management of asymptomatic AS patients.

Schlüsselwörter

asymptomatische Aortenstenose - Echokardiographie - Risikostratifikation

Keywords

asymptomatic aortic stenosis - echocardiography - risk stratification

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