When is a valve replacement indicated in aortic stenosis?
Following are the indications for the aortic valve replacement. Surgery is approved for: - Valve area < 0.8 cm2 with classic symptoms of AS - Severe high-gradient AS with classic symptoms - Severe AS during another cardiac surgery - Symptomatic with low-gradient or low-flow severe AS - Asymptomatic patients of severe AS with Left Ventricular Ejection Fraction (LVEF) < 50 - Asymptomatic patient of severe AS with low surgical risk - Patient with moderate AS and undergoing other cardiac surgery Transcatheter Aortic Valve Replacement is approved for: - Patient with severe AS and low to prohibitive surgical risk - Valve-in-valve procedures for patients with history of failed bioprosthetic valves
I believe valve replacement is primarily indicated for AS patients with symptomatic disease. In a symptomatic patients, echo is used to gauge the potential need for prophylactic replacement. The surgical risk of the patient is also considered.
