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Therapies to treat symptomatic severe aortic stenosis
From the 2017 ESC/EACTS guidelines for the management of valvular heart disease1
Intervention is indicated in symptomatic patients with:
Severe, high-gradient aortic stenosis
Severe, low flow, low-gradient aortic stenosis with reduced ejection fraction and evidence of flow (contractile) reserve excluding pseudo-severe aortic stenosis.
AS = Aortic Stenosis; LVFT = Left Ventricular Ejection Fraction; SAVR = Surgical Aortic Valve Replacement; TAVI = Transcatheter Aortic Valve Implantation.
a Surgery should be considered (lla C) if one of the following is present: peak velocity > 5.5m/s; severe valve calcification + peak velocity progression ≥ 0.3m/s per year; markedly elevated neurohormones (> threefold age-and sex-corrected normal range) without other explanation; severe pulmonary hypertension (systolic pulmonary artery pressure > 60 mmHG).
b See tables of recommendation in ESC/EACTS guidelines published here
1 Reference: Baumgartner, H., et al. (2017).2017 ESC/EACTS Guidelines for the management of valvular heart disease. European Heart Journal, Volume 38, Issue 36.21 September 2017. Pages 2739-2791.