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Indications for valve replacement in aortic stenosis in adults

Author
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

INTRODUCTION

Surgical aortic valve replacement and transcatheter aortic valve replacement (TAVR) 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 TAVR 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 replacement" and "Choice of therapy for symptomatic severe aortic stenosis".)

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

Other issues relating to the surgical AVR and TAVR, the medical management of patients with AS, and valve surgery in elderly adults are discussed separately. (See "Choice of prosthetic heart valve for surgical 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".)

APPROACH TO IDENTIFYING CANDIDATES FOR VALVE REPLACEMENT

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 2016. | This topic last updated: Fri Jan 16 00:00:00 GMT+00:00 2015.
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