Aortic Stenosis: Pathophysiology, Diagnosis, and Therapy

Am J Med. 2017 Mar;130(3):253-263. doi: 10.1016/j.amjmed.2016.10.005. Epub 2016 Nov 1.


The incidence of aortic stenosis increases with age, affecting up to 10% of the population by the eighth decade. Once symptoms develop, aortic stenosis is rapidly fatal. Proper management requires an understanding of the physiology and criteria used to define disease severity. There is no effective pharmacologic treatment. Surgical aortic valve replacement has been the gold standard treatment for decades. However, over the last 10 years transcatheter aortic valve replacement has emerged as an attractive, less-invasive option for appropriately selected patients. Refinements in valve design and delivery systems have led to widespread use of this breakthrough technology in selected patients. We review the pathophysiology, criteria for valve replacement, and the results of the trials comparing transcatheter aortic valve replacement with surgical aortic valve replacement.

Keywords: Aortic stenosis; Balloon valvuloplasty; Low-flow low-gradient aortic stenosis; Surgical aortic valve replacement; Transcatheter aortic valve replacement.

Publication types

  • Review

MeSH terms

  • Aortic Valve / surgery
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / physiopathology*
  • Aortic Valve Stenosis / surgery
  • Aortic Valve Stenosis / therapy
  • Asymptomatic Diseases / therapy
  • Heart Valve Prosthesis
  • Heart Valve Prosthesis Implantation
  • Humans