Shows LV hypertrophy, calcification and thickening of aortic valve cusps with reduced systolic opening. Dilatation and reduced contraction of LV indicate poor prognosis. Doppler quantitates systolic gradient and allows calculation of valve area.
Treatment: Aortic Stenosis Avoid strenuous activity in severe AS, even in asymptomatic phase (See Fig. 114-3). Treat heart failure in standard fashion (Chap. 124. Heart Failure and Cor Pulmonale), but use vasodilators with caution in pts with advanced disease. Valve replacement is indicated in adults with symptoms resulting from AS and hemodynamic evidence of severe obstruction. Transcatheter aortic valve implantation (TAVI) is an alternative approach for pts at excessive or prohibitive surgical risk. |