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How should very severe aortic stenosis be defined in asymptomatic individuals Philip green, md, facc ∗. Severe aortic stenosis (as) is currently defined by an aortic valve area (ava) <1.0 cm 2 and/or a mean transaortic pressure gradient (mpg) >40 mm hg and/or a peak aortic jet velocity (v max) >4 m/s

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Key takeaways from acc/aha guidelines symptomatic severe as → always replace the valve Isaac george, md, facc, faha ∗ Aortic valve stenosis is the most common cause of left ventricular (lv) outflow obstruction in children and adults

Less common causes are subvalvular or supravalvular disease (table 1)

This topic will review the clinical features, diagnosis, and evaluation of valvular aortic stenosis (as) [1]. Echocardiography is the main method to assess as severity It relies on three parameters, namely the peak velocity (pvel), the mean pressure gradient (mpg) and the aortic valve area (ava). The most important clinical question is whether an earlier aortic valve replacement (avr) can benefit those patients who have underlying myocardial disease and as whose severity is less than severe as currently defined.

In this setting, as severity should be confirmed using a multimodality imaging approach This review gives an overview of how to assess and/or confirm as severity, especially in case of discordance. Asymptomatic severe aortic stenosis (as) poses a clinical challenge with variations in recommendations for management We sought to compare contemporary guidelines focusing on asymptomatic as management and present a summary of contemporary studies on early intervention in these patients.

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Cardiac catheterization provides measurement of intracardiac and pulmonary pressures, valve severity, and hemodynamic response to exercise & drugs

Bonow, md, ms, macc, writing group chair Lindman, md, ms c, facc, faha, writing group representative Beaver, md, facc, faha ‡ Bradley, md, mph, facc, faha §

Carabello, md, facc, faha ∗ Desai, md, facc, faha ∗

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