i
Echocardiografic criteria for severe aortic stenosis:
- LVOT SVI > 35 ml/m² BSA,
- AV Vmax > 4,0 m/s,
- LVOT Vmax / AV Vmax  < 0,25,
- AV meanPG > 40 mmHg,
- AV Area < 1,0 cm², 
- Indexed AV Area < 0,6cm²/m² BSA.

Echocardiografic criteria for low flow low gradient severe aortic stenosis:
- LVOT SVI < 35 ml/m², 
- AV Vmax < 4,0 m/s,
- LVOT Vmax / AV Vmax  > 0,25,
- AV meanPG < 40 mmHg,
- AV Area < 1,0 cm²,
- Indexed AV Area < 0,6cm²/m² BSA. 

i

i

i

i

i

Class I indications for coronary angiography:

-acquired organic aortic stenosis requiring surgery + left ventricular systolic dysfunction,

-acquired organic aortic stenosis requiring surgery + history of coronary disease,

-acquired organic aortic stenosis requiring surgery + suspected myocardial ischemia,

-acquired organic aortic stenosis requiring surgery + > 1 cardiovascular risk factor,

-acquired organic aortic stenosis requiring surgery + men aged over 40 years,
-acquired organic aortic stenosis requiring surgery + postmenopausal women.

i

i

i

i

i

i

i

i

i

i

iClass I indications for aortic valve replacement with a mechanical aortic valve prothesis:
-acquired organic aortic stenosis requiring aortic valve replacement + absence of contraindications to anticoaugulation + high probability of effective anticoagulation,

-acquired organic aortic stenosis requiring aortic valve replacement + risk of accelerated biological aortic valve prothesis degeneration,
-acquired organic aortic stenosis requiring aortic valve replacement + mechanical heart valve prothesis in another position.

Class IIa indications for aortic valve replacement with a mechanical aortic valve prothesis:
-acquired organic aortic stenosis requiring aortic valve replacement + patients in whom life expectancy is reasonable and risk of  future redo aortic valve surgery is high,
-acquired organic aortic stenosis requiring aortic valve replacement + patients aged < 60 years.

Class IIb indications for aortic valve replacement with a mechanical aortic valve prothesis:

-acquired organic aortic stenosis requiring mitral aortic replacement + long-term anticoagulation because of high risk for thromboembolism.

Class I indications for aortic valve replacement with a biological aortic valve prothesis:
-acquired organic aortic stenosis requiring aortic valve replacement + contraindications to anticoaugulation,
-acquired organic aortic stenosis requiring aortic valve replacement + absence of contraindications to anticoaugulation + low probability of effective anticoagulation.

Class IIa indications for aortic valve replacement with a biological aortic valve prothesis:
-acquired organic aortic stenosis requiring aortic valve replacement + patients in whom risk of future redo mitral valve surgery is low,

-acquired organic aortic stenosis requiring aortic valve replacement + patients in whom life expectancy is lower than presumed durability of biological aortic valve prothesis,
-acquired organic aortic stenosis requiring aortic  valve replacement + patients aged  > 65 years,
-acquired organic aortic stenosis requiring aortic valve replacement + young woman contemplating pregnancy.

Class I indications for mechanical aortic valve prothesis replacement with a biological aortic valve prothesis:
-acquired organic aortic stenosis after aortic valve replacement with a mechanical aortic valve prothesis +  mechanical  aortic valve prothesis trombosis despite good long term anticoagulation.

i

i

Class I indications for CABG:

-acquired organic aortic stenosis requiring surgery + coronary artery diameter stenosis > 70%.

Class IIa indications for CABG:
-acquired organic aortic stenosis requiring surgery + coronary artery diameter stenosis = 50-70%.