The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

The surgeon’s corner

Indications for and outcomes of valve replacement for asymptomatic aortic valve stenosis

EuroIntervention 2013;9:23-27. DOI: 10.4244/EIJV9I1A4

Division of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA
Aortic valve stenosis (AS) may be unpredictable in that the degree of valve narrowing often does not correlate with the functional limitations of the patient. In current practice guidelines, aortic valve replacement (AVR) has a class I recommendation for symptomatic patients with severe AS, but valve replacement in asymptomatic patients has a class IIb recommendation.

The characteristics of asymptomatic patients with severe AS who are considered under this IIb recommendation include an abnormal response to exercise testing (development of hypotension and/or symptoms) and extremely severe AS (aortic valve area less than 0.6 cm2, mean gradient >60 mmHg, and jet ...

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