This will play a video - Medical experts, discussing diagnosis of symptomatic severe aortic stenosis (SSAS), from the Medtronic Transcatheter Aortic Valve Replacement (TAVR) cardiovascular group.

DIAGNOSING SYMPTOMATIC SEVERE AORTIC STENOSIS

Identify aortic stenosis criteria and treatment decision factors found in ACC/AHA Guidelines.
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ACC/AHA GUIDELINES UPDATES & KEY CONSIDERATIONS1

Shared decision-making between the patient and heart team is based on lifetime risks and benefits of mechanical vs. bioprosthesis and transcatheter vs. surgical intervention. 

Surgical risk stratification is no longer a factor for therapy selection. 

Browse complete details in summarized version of the Guidelines. 

 

EVALUATION & SHARED DECISION MAKING MODEL1

AGE

  • 65 to 80 years of age and no anatomic contraindications to transfemoral TAVR, Class 1-A for SAVR or transfemoral TAVR
  • >80 years of age or younger patients with life expectancy
    <10 years and no anatomical contraindication to transfemoral TAVR Class 1-A

ANATOMY

  • Transfemoral access is the preferred for all patients considered for TAVR Class 1-A
  • Coronary ostial heights, valve anatomy, and annular size should be considered

DURABILITY

  • The balance between expected patient longevity and valve durability varies continuously across the age range, with more durable valve preferred for patients with a longer life expectancy

    See the Decision Tree

Patients with severe VHD should be evaluated by a multidisciplinary heart valve team when intervention is considered.

ACC/AHA 2020 Guidelines
Female Medtronic cardiovascular physician as part of the Transcatheter Aortic Valve Replacement (TAVR) cardiovascular group discussing therapies.

URGENCY IS EVERYTHING FOR DIAGNOSIS AND TREATMENT

See why a proper echo is vital to diagnosing symptomatic severe aortic stenosis.
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Experts share why it’s important to go beyond gradients when detecting the severity of aortic stenosis.
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RECOGNIZE THE SIGNS OF SSAS1

A female Medtronic cardiovascular Transcatheter Aortic Valve Replacement (TAVR) medical professional providing information on diagnosis of symptomatic severe aortic stenosis (SSAS)

SEVERE HIGH-­GRADIENT AS

  • Aortic Vmax ≥ 4 m/s or ∆ Pmean ≥ 40 mm Hg
  • AVA typically ≤ 1.0 cm2 (or AVAi ≤ 0.6 cm2/m2) but may be larger with mixed AS/AR

SEVERE LOW­ FLOW/LOW­-GRADIENT AS WITH REDUCED LVEF

  • AVA ≤ 1.0 cm2 with resting aortic Vmax < 4 m/s or ∆ Pmean < 40mm Hg
  • Dobutamine stress echocardiography (DSE) shows AVA < 1.0 cm2 with Vmax ≥ 4 m/s at any flow rate

SEVERE LOW-GRADIENT AS WITH NORMAL LVEF OR PARADOXICAL LOW ­FLOW SEVERE AS

  • AVA ≤ 1.0 cm2 (indexed AVA ≤ 0.6 cm2/m2) with an aortic Vmax < 4 m/s or ∆ Pmean < 40 mm Hg AND
  • Stroke volume index < 35 ml/m2
  • Measured when patient is normotensive (systolic blood pressure < 140 mm Hg)

DEFER TO THE GUIDELINES

YOU AND THE GUIDELINES: A POWERFUL COMBINATION

Your expert care and the updated ACC/AHA guidelines work together to help your SSAS patients improve their chances of survival with a referral to the heart team for evaluation and treatment.

DOWNLOAD THE GUIDELINE CENTRAL APP
A chart icon representing Medtronic cardiovascular Transcatheter Aortic Valve Replacement (TAVR) and identifying aortic stenosis treatment criteria found in ACC guidelines.

Identify aortic stenosis criteria and treatment decision factors found in ACC/AHA Guidelines.

An application icon representing Medtronic cardiovascular Transcatheter Aortic Valve Replacement (TAVR) and referencing the aortic stenosis app for patient resources.

Download our aortic stenosis TAVR education app, which includes augmented reality views and patient resources.

A speakerphone icon representing Medtronic cardiovascular Transcatheter Aortic Valve Replacement (TAVR) and noting videos from heart valve treatment experts about TAVR patients.

Hear from heart valve treatment experts about the expansion of TAVR for low-risk patients.

A heart icon representing Medtronic cardiovascular Transcatheter Aortic Valve Replacement (TAVR) and learning more about SSAS symptoms and low-risk TAVR.

Learn more about SSAS symptoms and low-risk TAVR.

 

1

Otto CM, Nishimura RA, Bonow RO. et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. Published online December 17. 2020.