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比较早期干预与观察等待:无症状主动脉瓣狭窄的风险分层与管理综述

Comparing Early Intervention to Watchful Waiting: A Review on Risk Stratification and Management in Asymptomatic Aortic Stenosis.

作者信息

Khedr Ahmed E, Odeh Nour B, Bcharah George, Abdalla Hesham M, Senjab Abdulrahman, Zeineddine Rawan M, Ram Jaikrishnan, Farina Juan M, Crystal Owen R, Barrus Bryan, Lester Steven J, Shipman Justin, Alsidawi Said, Ayoub Chadi, Sell-Dottin Kristen A, Arsanjani Reza

机构信息

Department of Cardiothoracic Surgery, Mayo Clinic, Phoenix, AZ 85054, USA.

Department of Cardiothoracic Surgery, Mayo Clinic Alix School of Medicine, Phoenix, AZ 85054, USA.

出版信息

Medicina (Kaunas). 2025 Mar 4;61(3):448. doi: 10.3390/medicina61030448.

Abstract

Aortic stenosis is a progressive condition with substantial implications for morbidity and mortality. In recent years, attention has shifted toward risk stratification and the development of individualized management plans to optimize treatment outcomes. The management of asymptomatic patients has become a topic of significant controversy, as emerging studies challenge traditional watchful waiting guidelines and propose the potential benefits of early intervention. While early intervention may reduce overall morbidity and mortality in this patient population, the associated procedural risks remain a critical consideration. This review seeks to analyze the existing literature, offering an updated perspective on patient risk stratification and evidence evaluating both management approaches.

摘要

主动脉瓣狭窄是一种进行性疾病,对发病率和死亡率有重大影响。近年来,关注重点已转向风险分层以及制定个体化管理计划以优化治疗结果。无症状患者的管理已成为一个极具争议的话题,因为新出现的研究对传统的观察等待指南提出了挑战,并提出了早期干预的潜在益处。虽然早期干预可能会降低该患者群体的总体发病率和死亡率,但相关的手术风险仍然是一个关键的考虑因素。本综述旨在分析现有文献,就患者风险分层以及评估两种管理方法的证据提供最新观点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7e5/11943529/30ab64aee44a/medicina-61-00448-g001.jpg

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