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Indications for valve replacement in aortic stenosis in adults

William H Gaasch, MD
Section Editors
Catherine M Otto, MD
Gabriel S Aldea, MD
Edward Verrier, MD
Deputy Editor
Susan B Yeon, MD, JD, FACC


Surgical aortic valve replacement and transcatheter aortic valve implantation (TAVI) are the only effective treatments for severe aortic stenosis (AS). Recommendations for surgical valve replacement for AS are based upon comparisons of the natural history of patients with AS to outcomes after surgical aortic valve replacement (figure 1). Recommendations for TAVI for AS are based upon randomized trial and observational study data. (See "Natural history, epidemiology, and prognosis of aortic stenosis" and "Choice of prosthetic heart valve for surgical aortic or mitral valve replacement" and "Choice of therapy for symptomatic severe aortic stenosis".)

Indications for surgical AVR and TAVI for AS and choice of procedure are discussed here [1].

Other issues relating to the surgical AVR and TAVI, the medical management of patients with AS, and valve surgery in elderly adults are discussed separately. (See "Choice of prosthetic heart valve for surgical aortic or mitral valve replacement" and "Choice of therapy for symptomatic severe aortic stenosis" and "Medical management of asymptomatic aortic stenosis in adults" and "Medical management of symptomatic aortic stenosis" and "Valvular heart disease in elderly adults".)


The following are the key steps in determining whether a patient with aortic stenosis (AS) has an indication for valve replacement (algorithm 1):

Identification of the patient’s symptom status

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Literature review current through: Nov 2017. | This topic last updated: Dec 22, 2016.
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