Term
| Class I indications for AVR in AS |
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Definition
1. symptomatic severe high gradient AS
2. asymptomatic severe AS with LVEF < 50%
3. asymptomatic severe severe AS when undergoing cardiac surgery for another indication
4. Low flow/low gradient severe AS with reduced LVEF
5. symptomatic low-flow/low gradient severe AS with normal LVEF if AS is the most likely cuase of the symptoms |
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Term
| Class II indications for AVR in AS |
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Definition
1. apparently asympomtatic patients with severe AS and low surgical risk with exercise testing demonstrates decreased exercise tolerance or a fall in SBP > 10 mm Hg
2. asymptomatic patients with very severe AS (AV >/= 5 m/s) and low surgical risk
3. apparently asymptomatic patients with severe AS and low surgical risk when BNP > 3x normal
4. Asymptomatic patients with high gradient severe AS adn low surgical risk when velocity increases >/= 0.3 m/s per year
4. severe asymptomatic AS and a prgressive decrease in LVEF (to at least < 60%) on 3 successive imaging studies
5. moderate AS at the time of surgery for another reason. |
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Term
| Parameters for moderate AS |
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Definition
AVA- 1.1 - 1.5
peak velocity- 3-3.9 m/s
Mean gradient- 20-39 mm Hg |
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Term
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Definition
AVA < 1.0 m2
mean gradient > 40 mm Hg
peak velocity > 4 m/s |
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Term
| Patient < 50 yo who needs an AVR for AS: what type of valve and what approach |
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Definition
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Term
| Patient 50 - 65 yo who needs AVR for AS: what type of valve and approach |
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Definition
# individualized approach to mechanical vs. bioprosthetic
# SAVR if they have more than 20 year life expectancy |
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Term
| Patients who should definitely get TAVR over SAVR |
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Definition
# > 80 yo with < 10 year life expectancy
# patients with prohibitive surgical risk (STS PROM > 8%) |
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Term
| Patient > 65 who needs an SAVR: what type of valve |
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Definition
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Term
| Class I indications for AVR for AI |
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Definition
# severe AI with symptoms
# asymptomatic severe AI with LVEF < 50%
# asymptomatic severe AI while undergoing cardiac surgery for another indication |
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Term
| Class II indications for AVR for AI |
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Definition
# asymptomatic AI with LVEF > 50% and:
LVESD > 50 mm or LVEDD > 65 mm
# Progressive AI while undergoing cardiac surgery for another indication |
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