Aortic valve surgery in patients with congestive heart failure

Abstract

Aortic valve disease commonly presents with symptoms of congestive heart failure. The medical management of these patients is associated with poor outcomes. Aortic valve replacement improves outcomes. However, patient selection and preoperative evaluation is challenging. Advance age, associated comorbidities, and frailty may limit their life expectancy in addition to the cardiac disease. These factors should be carefully considered to risk stratify and guide the decision to perform surgery. This chapter reviews the evaluation, management, and outcomes of patients with congestive heart failure secondary to aortic valve disease with normal and low left ventricular ejection fraction. The advent of transcatheter aortic valve replacement promises to revolutionize the way these patients are managed, offering an alternative treatment to patients who previously were considered not candidates for surgery.