Cosmo Godino։ Aortic Stenosis Is More Than a Valve Disease
Cosmo Godino, Medical Doctor at San Raffaele Hospital, shared a post on LinkedIn:
”For years, we have defined aortic stenosis using rigid cut-offs: AVA less than 1 cm²Mean gradient greater than 40 mmHg.
But clinical practice teaches us something different.
Some patients with ‘only’ moderate aortic stenosis are highly symptomatic, develop pulmonary hypertension, myocardial damage, heart failure, and experience major cardiovascular events.
Meanwhile, others with similar valve parameters remain relatively stable.
Why?
Because aortic stenosis is not just a valve disease.
The impact on the myocardium, filling pressures, pulmonary circulation, renal function, associated valvular disease and overall patient complexity may matter more than the valve gradient itself.
Our recently published SPARK score moves in this direction: a broader and more tailored evaluation of patients with moderate AS.
Medicine is changing.
We need to move beyond old and limited cut-offs toward a more patient-centered and individualized approach.
Because we should treat patients – not numbers.”
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