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Volume 13
Issue 12
10.3390/diagnostics13122102
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Review

Beyond Aortic Stenosis: Addressing the Challenges of Multivalvular Disease Assessment

by
Sara Bombace
1,
Maria Chiara Meucci
2,
Federico Fortuni
3,4,
Federica Ilardi
5,
Rachele Manzo
5,
Grazia Canciello
5,
Giovanni Esposito
5,
Paul A. Grayburn
6,
Maria Angela Losi
5 and
Anna Sannino
5,6,*
1
Leipzig Heart Science, 04289 Leipzig, Germany
2
Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
3
Department of Cardiology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands
4
Department of Cardiology, San Giovanni Battista Hospital, 06034 Foligno, Italy
5
Department of Advanced Biomedical Sciences, Division of Cardiology, Federico II University, 80131 Naples, Italy
6
Baylor Scott & White Research Institute, Plano, TX 75093, USA
*
Author to whom correspondence should be addressed.
Diagnostics 2023, 13(12), 2102; https://doi.org/10.3390/diagnostics13122102
Submission received: 17 May 2023 / Revised: 12 June 2023 / Accepted: 14 June 2023 / Published: 17 June 2023
(This article belongs to the Section Medical Imaging and Theranostics)
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Abstract

Aortic stenosis (AS) can often coexist with other valvular diseases or be combined with aortic regurgitation (AR), leading to unique pathophysiological conditions. The combination of affected valves can vary widely, resulting in a lack of standardized diagnostic or therapeutic approaches. Echocardiography is crucial in assessing patients with valvular heart disease (VHD), but careful consideration of the hemodynamic interactions between combined valvular defects is necessary. This is important as it may affect the reliability of commonly used echocardiographic parameters, making the diagnosis challenging. Therefore, a multimodality imaging approach, including computed tomography or cardiac magnetic resonance, is often not just beneficial but crucial. It represents the future of diagnostics in this intricate field due to its unprecedented capacity to quantify and comprehend valvular pathology. The absence of definitive data and guidelines for the therapeutic management of AS in the context of multiple valve lesions makes this condition particularly challenging. As a result, an individualized, case-by-case approach is necessary, guided primarily by the recommendations for the predominant valve lesion. This review aims to summarize the pathophysiology of AS in the context of multiple and mixed valve disease, with a focus on the hemodynamic implications, diagnostic challenges, and therapeutic options.
Keywords: aortic stenosis; multiple valve disease; mixed valve disease; echocardiography; multimodal imaging aortic stenosis; multiple valve disease; mixed valve disease; echocardiography; multimodal imaging

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MDPI and ACS Style

Bombace, S.; Meucci, M.C.; Fortuni, F.; Ilardi, F.; Manzo, R.; Canciello, G.; Esposito, G.; Grayburn, P.A.; Losi, M.A.; Sannino, A. Beyond Aortic Stenosis: Addressing the Challenges of Multivalvular Disease Assessment. Diagnostics 2023, 13, 2102. https://doi.org/10.3390/diagnostics13122102

AMA Style

Bombace S, Meucci MC, Fortuni F, Ilardi F, Manzo R, Canciello G, Esposito G, Grayburn PA, Losi MA, Sannino A. Beyond Aortic Stenosis: Addressing the Challenges of Multivalvular Disease Assessment. Diagnostics. 2023; 13(12):2102. https://doi.org/10.3390/diagnostics13122102

Chicago/Turabian Style

Bombace, Sara, Maria Chiara Meucci, Federico Fortuni, Federica Ilardi, Rachele Manzo, Grazia Canciello, Giovanni Esposito, Paul A. Grayburn, Maria Angela Losi, and Anna Sannino. 2023. "Beyond Aortic Stenosis: Addressing the Challenges of Multivalvular Disease Assessment" Diagnostics 13, no. 12: 2102. https://doi.org/10.3390/diagnostics13122102

APA Style

Bombace, S., Meucci, M. C., Fortuni, F., Ilardi, F., Manzo, R., Canciello, G., Esposito, G., Grayburn, P. A., Losi, M. A., & Sannino, A. (2023). Beyond Aortic Stenosis: Addressing the Challenges of Multivalvular Disease Assessment. Diagnostics, 13(12), 2102. https://doi.org/10.3390/diagnostics13122102

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