Aortic stenosis is classed as severe if
For example, if the patient has severe aortic stenosis and poor LV function, the low ejection fraction through a severely narrowed aortic valve would produce a soft murmur, despite the aortic stenosis being severe.
Subsequently, on echo, it is not uncommon to underestimate the gradient across the aortic valve when there is coexistent LV impairment.
In such circumstances, a dobutamine stress echo may be useful.
Class I indications for aortic valve surgery
1. Blase A. Carabello Evaluation and Management of Patients With Aortic Stenosis Circulation. 2002;105:
- Patient is symptomatic - chest pain, syncope, breathlessness
- Mean gradient > 40 mmHg
- Aortic valve area < 1.0 cm2
For example, if the patient has severe aortic stenosis and poor LV function, the low ejection fraction through a severely narrowed aortic valve would produce a soft murmur, despite the aortic stenosis being severe.
Subsequently, on echo, it is not uncommon to underestimate the gradient across the aortic valve when there is coexistent LV impairment.
In such circumstances, a dobutamine stress echo may be useful.
Class I indications for aortic valve surgery
- Symptomatic aortic stenosis
- Along with coronary artery bypass grafting
- As a part of aortic root surgery
- Severe AS with LV impairment < 50%
1. Blase A. Carabello Evaluation and Management of Patients With Aortic Stenosis Circulation. 2002;105:
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