Key diagnostic steps in aortic stenosis (AS) echocardiography

  • With an average survival rate of 50% at two years and 20% at five years, the timely and accurate diagnosis of AS is essential1

  • An integrated and stepwise approach to echocardiography assessment of AS is a key diagnostic tool for confirming the diagnosis and severity of AS2

  • However, it is important to understand the limitations of echocardiography to avoid the underestimation of AS severity3,5

Challenges in treating patients with asymptomatic severe aortic stenosis (sAS)
  • Roughly 1/3 of patients with severe aortic stenosis (sAS) are asymptomatic and once symptoms develop their average survival declines1,2

  • Symptom detection is difficult with many patients attributing them to other factors3,4. Exercise testing is important for unmasking symptoms in patients with asymptomatic sAS5

  • Treatment is recommended in patients with asymptomatic severe aortic stenosis in the presence of one or more of these factors: adverse prognostic factors*, LVEF<50%, positive exercise test† or symptom development6

The 2021 ESC/EACTS guidelines recommend all* sAS patients with severe aortic stenosis are referred to the Heart Team1

The new 2021 ESC/EACTS VHD guidelines recommend that all* symptomatic patients with severe aortic stenosis (sAS) are referred to the Heart Team for a treatment evaluation. The Heart Team will assess multiple patient factors, including their age, their values and preferences, when making the final decision between TAVI and SAVR.1

* With treatment indication. 1

Podcast Episode 4 – Benchmarking Efficiencies, Pre, Peri and Post TAVI Procedure

Tavi podcast series

In the fourth instalment of the TAVI Talk podcast series Interventional Cardiologists Dr. Sagar Doshi from The Queen Elizabeth Hospital, Birmingham and Dr. Charis Costopoulos from Royal Papworth Hospital discuss optimization of the pre, peri and post TAVI procedure.

How can TAVI benefit your low-risk patients with severe aortic stenosis (sAS) now and in the future?

Supported by proven results from PARTNER 3,1 low-risk patients with sAS now have the opportunity for TAVI. As these patients are usually younger and healthier than those in higher risk categories,1-6 further considerations for this group include valve durability and valve-in-valve (ViV) procedures that support their longer-term management.

Podcast Episode 3 – The Collaborative Referral

Tavi podcast series

In the third instalment of the TAVI Talk podcast series, Interventional Cardiologist Dr. Karim Ratib from Royal Stoke University Hospital and Dr. Andrew Epstein, Cardiologist from Wye Valley NHS Trust discuss their Aortic Stenosis Management Service for best patient outcome.

How to avoid the pitfalls of underdiagnosing severe aortic stenosis (sAS)

The characterisation of aortic stenosis (AS) severity remains an ongoing challenge in clinical practice. Patients with discordant echocardiographic indices are commonly described in reports as having less than sAS despite meeting the criteria for sAS. Understanding the limitations of echocardiographic and adopting a step-by-step integrative approach to confirm AS severity can help meet the challenge.1-3

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