Current Advances in Aortic Valve Stenosis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 2849

Special Issue Editor


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Guest Editor
Department of Interventional Cardiologist and THV Program, Athens Medical Center, 15125 Athens, Greece
Interests: interventional cardiology; coronary artery disease; valvulopathies and structural heart diseases

Special Issue Information

Dear Colleagues,

The prevalence of aortic stenosis (AS) in the community is an issue of great interest. It is expected that the burden of AS will increase because of the ageing population, and the prevalence will have doubled by 2050. The development of 3/4D reconstruction imaging assessments has bought about further possibilities with a high diagnostic ability. The progress of a minimally invasive and transcutaneous management approach in the era of structural heart diseases is remarkable. Various vavulopathies (such as aortic stenosis, mitral regurgitation or tricuspid valve regurgitation, etc.), which were previously untreatable due to high surgical risk, can now be treated. Based on the results of well-organized randomized control trials, transcutaneous aortic valve replacement (TAVI) has shown itself to be comparable to surgery results in terms of outcome and mortality, and, as a consequence, the therapeutic indications of TAVI have expanded from high and inoperable risk patients to intermediate and even lately to lower risk patients. However, despite technological progress being made and increased operator expertise, there are still issues that remain to be discussed. In this Special Issue, we invite authors to submit papers focused on the clinical advancements of AS in terms of long-term management.

Dr. Antonios Halapas
Guest Editor

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Keywords

  • valvular heart diseases
  • aortic stenosis
  • prevention
  • diagnosis
  • management

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Published Papers (3 papers)

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Research

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9 pages, 206 KiB  
Article
Does Intra-Annular Valve Design Equal Intra-Annular Valve Design? Comparison of Two Transcatheter Aortic Valve Prostheses
by Clemens Eckel, Fadi Al-Rashid, Sophie Bargon, Judith Schlüter, Dagmar Sötemann, Albrecht Elsässer, Johannes Blumenstein, Helge Möllmann and Christina Grothusen
J. Clin. Med. 2025, 14(6), 1824; https://doi.org/10.3390/jcm14061824 - 8 Mar 2025
Viewed by 529
Abstract
Background: Prosthesis-patient mismatch (PPM) has been demonstrated to affect the outcome of both surgical (SAVR) and transcatheter aortic valve replacement (TAVR) patients. Supra-annular transcatheter valves (SAV) appear to offer a superior solution to intra-annular valves (IAV) in this regard. However, data on the [...] Read more.
Background: Prosthesis-patient mismatch (PPM) has been demonstrated to affect the outcome of both surgical (SAVR) and transcatheter aortic valve replacement (TAVR) patients. Supra-annular transcatheter valves (SAV) appear to offer a superior solution to intra-annular valves (IAV) in this regard. However, data on the comparison of the intra-annular self-expanding (SE) NAVITOR and the intra-annular balloon-expandable (BE) Sapien 3 Ultra in small annuli are limited. Methods: A total of 179 patients with severe native aortic valve stenosis were treated with either the SE NAVITOR (SEV; n = 104) or the BE Sapien 3 Ultra (BEV; n = 75) between March 2019 and June 2024. We compared the clinical and hemodynamic outcomes of the cohort according to the implanted prostheses. BMI-adjusted PPM was defined in accordance with the VARC-3 recommendations. Results: The device success at 30 days was superior in patients treated with the NAVITOR prosthesis (94.2% vs. 80.0%, p < 0.001), mainly driven by a higher rate of elevated gradients in the BEV group. The post-procedural mean gradient (8.0 mmHg vs. 13.0 mmHg, p < 0.001) as well as the rate of moderate to severe prosthesis patient mismatch (12.2% vs. 33.3%, p = 0.002) was higher in BEV recipients while the rate of more than moderate paravalvular leakage (PVL) or Valve in Valve (VinV) due to PVL (1.0% vs. 1.3%, p = 1.000) was similar between both groups. Pacemaker implantations were numerically more common after SEV (18.4% vs. 8.5%, p = 0.110). There was a trend towards higher thirty-day all-cause mortality among patients treated with SAV (3.8% vs. 1.3%, p = 0.401). Conclusion: The NAVITOR system may offer a more favorable hemodynamic profile compared to the Sapien 3 Ultra device in patients with small aortic annuli. Full article
(This article belongs to the Special Issue Current Advances in Aortic Valve Stenosis)
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Review

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12 pages, 753 KiB  
Review
Diagnostic Challenges in the Management of Aortic Valve Stenosis and the Role of Imaging: A Narrative Review
by Dimitrios Karelas, Evangelos Tatsis, Dimitrios Oikonomidis and Constantinos Hristou Papadopoulos
J. Clin. Med. 2025, 14(4), 1231; https://doi.org/10.3390/jcm14041231 - 13 Feb 2025
Viewed by 763
Abstract
Aortic valve stenosis (AS) is a prevalent and progressive valvular disease that poses significant diagnostic challenges, particularly in low-flow, low-gradient (LF-LG) states. Accurate assessment of AS severity is crucial for timely intervention and improved clinical outcomes. This narrative review critically evaluates the limitations [...] Read more.
Aortic valve stenosis (AS) is a prevalent and progressive valvular disease that poses significant diagnostic challenges, particularly in low-flow, low-gradient (LF-LG) states. Accurate assessment of AS severity is crucial for timely intervention and improved clinical outcomes. This narrative review critically evaluates the limitations of conventional echocardiographic techniques and explores the role of multimodal imaging—including advanced echocardiography, computed tomography (CT), and cardiac magnetic resonance (CMR)—in enhancing diagnostic accuracy. Special emphasis is placed on the unique challenges of LF-LG AS, where standard Doppler-derived assessments may misclassify disease severity, necessitating a more integrative diagnostic approach. By addressing these key diagnostic uncertainties and proposing a multimodal framework for improved assessment, this review provides a comprehensive update on best practices in AS evaluation, with the goal of optimizing clinical decision making and patient outcomes. Full article
(This article belongs to the Special Issue Current Advances in Aortic Valve Stenosis)
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14 pages, 1043 KiB  
Review
Aortic Stenosis Prevention: Is a New Cardiovascular Disease Paradigm Coming of Age?
by Antonios Halapas and Dennis V. Cokkinos
J. Clin. Med. 2025, 14(3), 903; https://doi.org/10.3390/jcm14030903 - 29 Jan 2025
Viewed by 1082
Abstract
Calcific aortic stenosis (CAS) is currently recognized as the third most frequent cardiovascular disorder in persons aged above 60 years, after atherosclerotic disease and hypertension, and together with its precursor aortic sclerosis it has been found in more than 30% of elderly individuals. [...] Read more.
Calcific aortic stenosis (CAS) is currently recognized as the third most frequent cardiovascular disorder in persons aged above 60 years, after atherosclerotic disease and hypertension, and together with its precursor aortic sclerosis it has been found in more than 30% of elderly individuals. CAS is an active multifactorial process characterized by a progressive fibro-calcific remodeling and thickening of the AV leaflets caused by hemodynamic flow factors, genetic factors, lipoprotein deposition, oxidation, chronic inflammation, immunomodulators, and finally osteoblastic transformation of cardiac. Herein a comprehensive state-of-the-art paper is presented regarding the underlying pathophysiological mechanisms of CAS and the potential preventive strategies as an alternative to surgical and interventional treatment. Full article
(This article belongs to the Special Issue Current Advances in Aortic Valve Stenosis)
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