Complications
Heart failure occurs when the afterload burden created by the AS limits the ability of the left ventricle to pump blood to the body. Treatment of heart failure in AS is difficult. Diuretics and careful afterload reduction with vasodilators is the best option.
Beta-blockers and calcium-channel blockers should be used cautiously if at all because of their negative inotropic effects on the left ventricle. Therapy for symptomatic AS must address the underlying stenosis via surgical valve replacement or balloon valvuloplasty.
Sudden cardiac death due to ventricular arrhythmia is very rare in asymptomatic patients (1%) but is a significant concern in symptomatic patients.[85]
Sudden cardiac death due to ventricular arrhythmia is very rare in asymptomatic patients (1%) but is a significant concern in symptomatic patients.[85]
Any prosthetic valve is at risk for infection, and any fever or signs of valve dysfunction should prompt blood cultures and evaluation of valve function.
Mechanical valves are subject to thrombosis and embolization and require lifelong anticoagulation.
If patients have a return of preoperative symptoms after replacement, restenosis should be considered.
Suspected when patients develop new signs of heart failure or have a diastolic murmur of aortic regurgitation.
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