Aortic Stenosis Guidlines Flashcards
Mild AS
AVA: 1.5-2.5
Mean Gr: <20 mmHg
velocity: 2-3 m/s
Moderate AS
AVA: 1-1.5
Mean GR: 20-40 mmHg
Velocity: 3-4 m/s
Severe As
AVA:
mean GR: >40 mmHg
Velocity: >4 m/s
Stage A AS
— At risk
- BAV, AV sclerosis
- V max < 2m/s
Stage B AS
— Progressive AS
- mild-mod leaflet calc.
- rheumatic valve comm fusion
- Normal LVEF
- no Sx
Stage C AS
Asymptomatic severe AS
Stage C1 AS
— Asymptomatic severe AS
- severe calc
- congenital stenosis
- LV diastolic dysfunction
- normal EF
Stage C2 AS
— Asymptomatic severe AS with LV dysfunction
- Severe calc
- congenital stenosis
- LV sys dysfunction
- EF < 50%
Stage D AS
Symptomatic severe AS
Stage D1 AS
— Sx, severe high gradient AS
- severe leaflet calc or cong stenosis
- severe reduced leaflet opening
- LV diastolic dys, LV hypert, +- PHT
- dyspnea, anigina syncope
Stage D2 AS
— Sx severe low flow/low Gr AS
- severe leaflet calc
- reduced leafltet motion
- LV diast dysf, LV hypert, EF <50%
- HF, angina, syncope
Stage D3 AS
— Sx severe low Gr AS with normal EF
- or paradoxical low flow severe AS
- severely reduced leaflet motion
- increased LV wall TH, small LV chamber
- resticctive diastolic filling, EF <50%
- HF, angina, Syncope
Class I (B)
– AVR: Sx + sev. high GR AS (D1) + Sx on hx or ex T
– AVR: Asx + sev AS (C2) + EF < 50%
— AVR: sev AS (C or D) + other cardiac S
Class IIa (B)
AVR : ASx + very sev AS (C1), vel>5m/s + low surg risk
AVR: Asx + sev AS (C1) + exercise int as fall in BP
AVR: low flow/ low GR sev AS +low EF (D2) + ve dob E
Class IIa (C)
— AVR: Sx + low flow/ low GR sev AS (D3) normotensive and have normal EF if all date supp valve obstruc. as cause of Sx
— AVR: mod AS (B) + another cardiac surgery
