Table 1

 Recommendations for aortic valve replacement in asymptomatic severe AS

Indication classACC/AHA guidelines3ESC Recommendations4
ACC, American College of Cardiology; AHA, American Heart Association; AS, aortic stenosis; ESC, European Society of Cardiology; LV, left ventricle.
I Patients undergoing coronary artery bypass surgeryPatients undergoing coronary artery bypass surgery
I Patients undergoing surgery of the ascending aortaPatients undergoing surgery of the ascending aorta
IIa Patients with systolic left ventricular dysfunctionPatients with systolic left ventricular dysfunction
IIa Patients with abnormal response to exercise (for example, hypotension)Patients with abnormal response to exercise (development of symptoms, blood pressure fall, blood pressure rise <20 mm Hg, impaired exercise tolerance (<80%), new ST depression >2 mm, complex ventricular arrhythmias)
IIa Patients with moderate to severe valve calcification, a peak jet velocity >4 m/s, and a rate of peak velocity progression ⩾0.3 m/s/year
IIb Patients with excessive LV hypertrophy (⩾15 mm)Patients with severe LV hypertrophy (>15 mm)
Unless this is due to hypertension
IIb Patients with ventricular tachycardiaPatients with complex ventricular arrhythmias for which no other cause can be identified
IIb Patients with valve area <0.6 cm2