Aortic Stenosis: clinical approach

Abstract

Aortic stenosis, a heart condition marked by the narrowing of the aortic valve, compromises blood flow from the heart to the aorta and other regions of the body. This condition may be innate or develop with aging, and its prevalence has increased, particularly among the elderly, due to the aging of the world population. Risk factors include advanced age, history of valve disease, hypertension, hypercholesterolemia, smoking, physical inactivity and an inadequate diet. A literature review was used, using databases such as PubMed, Medline, SciELO and Google Scholar. Studies were selected in Portuguese and English that specifically address aortic stenosis, using specific descriptors and Boolean operators to refine the search. The reviewed studies emphasize the need for personalized treatment for aortic stenosis, given the wide range of therapeutic options that range from conventional surgeries to minimally invasive techniques such as TAVR and MIAVR. These modern approaches are particularly beneficial for patients who are high risk or unsuitable for traditional surgery, significantly improving heart function and life expectancy. However, careful patient selection, considering variations in risk profiles and outcome expectations, is crucial to ensure the effectiveness of treatments. Technical advances and better risk stratification are essential to optimize outcomes and minimize risks. The management of aortic stenosis must be adapted to the peculiarities of each patient, incorporating technological innovations. The evolution of clinical guidelines, moving towards less invasive and more personalized practices, is crucial to improving clinical outcomes.