When is aortic valve replacement indicated?

Class I indications: severe AS (AVA 0.3 m/s/year), very severe AS (Vmax ≥5 m/s), or undergoing other cardiac surgery.

What is paradoxical low-flow low-gradient AS?

PLF-LG AS: AVA <1.0 cm² with mean gradient <40 mmHg despite preserved LVEF (≥50%). Caused by reduced stroke volume due to concentric LVH and diastolic dysfunction. Treated similarly to classic severe AS — TAVR or SAVR based on risk.

TAVR vs SAVR: how is the decision made?

For severe symptomatic AS: TAVR is preferred in high/prohibitive surgical risk (STS score >8%). Intermediate risk (STS 4–8%): TAVR and SAVR have comparable outcomes (PARTNER 2, SURTAVI). Low risk (STS <4%): TAVR is now an approved alternative (PARTNER 3, Evolut Low Risk).

Aortic Stenosis Severity Classification Calculator

Classifies aortic stenosis severity by echocardiographic criteria: Mild AS: AVA >1.5 cm², mean gradient <25 mmHg, Vmax <3.0 m/s. Moderate AS: AVA 1.0–1.5 cm², mean gradient 25–40 mmHg. Severe AS: AVA <1.0 cm², mean gradient >40 mmHg, Vmax >4.0 m/s.

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Frequently Asked Questions

When is aortic valve replacement indicated?

What is paradoxical low-flow low-gradient AS?

TAVR vs SAVR: how is the decision made?