SYM = SYMptomatic (see HPI). ASYM = ASYMptomatic. CARD-SUR = Patient is due for CARDiac SURgery for reasons other than the aortic stenosis (e.g., CABG). MOD-AS = MODerate Aortic Stenosis by echocardiography. SEV-AS = SEVere Aortic Stenosis by echocardiography = Aortic valve area ≤1.0 cm2, decreased valve opening and aortic velocity ≥4.0 m/s or mean P gradient ≥40 mm Hg. LVSD = Left Ventricular Systolic Dysfunction with ejection fraction <0.50. FOLLOW = Clinical FOLLOW up and annual echocardiogram or sooner if symptoms develop. If a patient has severe aortic stenosis very close follow-up is needed and consideration should be given for exercise stress testing to objectively determine if a patient is genuinely asymptomatic. LG-AS = Low Gradient Aortic Stenosis. If LV function is low it is possible the LV cannot generate enough pressure to reveal the true severe gradient across the aortic valve. Consider dobutamine echo to enhance LV function. If LV function improves significantly and severe aortic stenosis is seen, refer for AVR. AVR = Refer for Aortic Valve Replacement. If patient is due for cardiac surgery for other reasons, AVR is performed at the same time to reduce perioperative risk and need for repeat thoracotomy. TAVR = Transcatheter Aortic Valve Replacement for patients with indication but prohibitive risk for surgical AVR and a predicted post-TAVR survival >12 months. |