Rick A. Nishimura et al. JACC 2014;63:e57-e185

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Rick A. Nishimura et al. JACC 2014;63:e57-e185 Indications for AVR in Patients With AS Arrows show the decision pathways that result in a recommendation for AVR. Periodic monitoring is indicated for all patients in whom AVR is not yet indicated, including those with asymptomatic AS (stage D or C) and those with low-gradient AS (stage D2 or D3) who do not meet the criteria for intervention. *AVR should be considered with stage D3 AS only if valve obstruction is the most likely cause of symptoms, stroke volume index is <35 mL/m2, indexed AVA is ≤0.6 cm2/m2, and data are recorded when the patient is normotensive (systolic BP <140 mm Hg). AS indicates aortic stenosis; AVA; aortic valve area; AVR, aortic valve replacement by either surgical or transcatheter approach; BP, blood pressure; DSE, dobutamine stress echocardiography; ETT, exercise treadmill test; LVEF, left ventricular ejection fraction; ΔPmean, mean pressure gradient; and Vmax, maximum velocity. Rick A. Nishimura et al. JACC 2014;63:e57-e185 American Heart Association, Inc., and the American College of Cardiology Foundation