Severe Aortic Valve Disease

Trans-catheter Aortic Valve Replacement (TAVR) in patients with aortic valve disease

Consideration criteria:

  • Symptomatic calcific aortic stenosis w/ NYHA functional ≥class II symptoms
  • Echo metrics: Mean gradient >40 mmHg OR Jet velocity > 4.0m/sec AND Initial AoVA < 0.8 cm² or indexed EOA < 0.5 cm²/m²

Testing before referral:

  • Trans-thoracic echocardiogram assess: valve metrics, annulus size.
  • Cardiac catheterization assess: significant CAD requiring revascularization and AoV.
  • Send images in DICOM format to:
Center for Structural Heart Disease
2799 West Grand Boulevard K-14
Detroit Michigan 48202

Process after referral:

  • CT: gated coronary, abdomen and pelvis following specific TAVR protocol to assess valve & peripheral anatomy for peripheral approaches.
  • Determination of Surgical Mortality Risk
  • Evaluation by two cardiac surgeons. One may be performed prior to referral.
  • Multidisciplinary conference to review all testing and determine treatment options
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