Thread by @vass_vassiliou

Educational Thread (longish) on AORTIC STENOSIS on the new #ESCGuidelines #ESCCongress published at @escardio #EHJ academic.oup.com/eurheartj/adva… Another thread to follow on AR. So truly excited about these guidelines and here’s why @mirvatalasnag @mmamas1973 @DrMarthaGulati @Hragy …/2

First things first #ESCCongress - a patient centered approach recommended. 👏 but I thought we had long moved to a patient centred approach but nonetheless good to highlight #epeeps #cardio #echofirst #whycmr …/3

#ESCCongress valve guidelines - and the role of the Heart Team re- emphasized. This is crucial. But also defining who should be present to constitute a ‘Heart Team’ @milena_mate @MelissaLyleMD @drzgezdentok1 @AScatteia @RositaZakeri @pacman8it @dr_benoy_n_shah @tchaaban1 …/4

#ESCCongress Valve #ESCGuidelines thread … and Oops, I uploaded the front of the heart failure guidelines (did a tweet on that yesterday- see below for that…. not the valves! And Here is the valves!!! From #EHJ @ehj_ed academic.oup.com/eurheartj/adva… …/5

https://twitter.com/vass_vassiliou/status/1431366041855213571

#ESCCongress Valve #ESCGuidelines thread. This summarises well… intervention 4 symptoms 👏, drop in BP on ETT 👏, and then the ‘bombshell’ if >75 TAVI! Are we talking physical age or biological age. I live in a region with life expectancy of 90….🤨 @J_Hendriks1 @EkateriniL …/6

But wait !!#ESCCongress Valve thread on #ESCGuidelines What is this mentioned in the text but not the diagram… Early intervention maybe considered…. YES, but on basis of what? And what is the recommendation for that? Not mentioned… hmmm… more questions than answers here …/7

#ESCCongress #ESCGuidelines Valve thread. A comment about surgical AF ablation in patients with AF. I like this a lot…but all of a sudden, what do we do with patient who are 76 and according to these guidelines should get TAVI… do an LAAO? I know it’s ‘no’ but just saying …/8

#ESCCongress #ESCGuidelines Valve Thread. NEW ADDITION LVEF<55% (attributed to AS) CONSIDER INTERVENTION👏 totally agree with this. @DBelardoMD @purviparwani …/9

#ESCCongress #ESCGuidelines Valve thread And when it comes to@intervention some GUIDANCE FOR SAVR vs #tavi #Tavr Just Guidance, but not sure about the age cut off personally … I ve seen some extremely fit 76 year old running marathons … /10

#ESCCongress #ESCGuidelines Valve thread And some helpful through a about medical therapy (what?) - sadly none at present- and see ial testing in Aortic Stenosis - nicely summarised KEY TREAT HYPERTENSION IN AORTIC STENOSIS
@AnastasiaSMihai @DrVikasKapil …/12 (last one!)

Last tweet on #ESCCongress #ESCGuidelines valves. My summary: Like the move to EF<55%, like the surgical MAZE, like the patient emphasis and heart team, unclear about age cut-off and TREAD hypertension. Unclear what they recommend about early indicators of harm…12/12 THE END