What are the AHA/ACC treatment guidelines for aortic stenosis (AS) in noncardiac surgery patients with valvular heart disease?

Updated: Jul 16, 2021
  • Author: Lindsay A (Finger) Raleigh, MD; Chief Editor: Sheela Pai Cole, MD  more...
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Answer

Answer

Once symptoms are present, outcomes are extremely poor unless an intervention to relieve obstruction occurs. Accordingly, the 2014 American Heart Association (AHA)/American College of Cardiology (ACC) guideline for the management of patients with valvular heart disease made the following recommendations [8] :

  • Aortic valve replacement (AVR) is recommended in patients with symptomatic severe AS (stage D) promptly after the onset of symptoms unless significant comorbid conditions exist that would prevent intervention (class I recommendation; level of evidence, B)
  • AVR is also recommended for asymptomatic patients with severe AS and an LVEF of less than 50% (stage C2); in these patients, survival is better for those who undergo AVR than for those treated medically (class I recommendation; level of evidence, B)

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