Why the study?
New studies on aortic stenosis, especially low gradient aortic stenosis, have emerged since 2009, necessitating updated echocardiographic assessment recommendations.
This focused update provides standardized echocardiographic algorithms and a new classification system for evaluating complex subgroups like low-flow, low-gradient aortic stenosis.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“There is inconsistency in the management of patients with aortic valve disease with a lack of evidence-based guidelines in pediatric patients. Reduction in clinical practice variability in pediatric cardiac patients has been associated with improved resource utilization and patient outcomes.”
Standardized echocardiographic criteria are needed to reduce practice variability in pediatric aortic stenosis; leaves open development of evidence-based guidelines.
Echocardiography is the key tool for the diagnosis and evaluation of aortic stenosis. Because clinical decision-making is based on the echocardiographic assessment of its severity, it is essential that standards are adopted to maintain accuracy and consistency across echocardiographic laboratories. Detailed recommendations for the echocardiographic assessment of valve stenosis were published by the European Association of Echocardiography and the American Society of Echocardiography in 2009. In the meantime, numerous new studies on aortic stenosis have been published with particular new insights into the difficult subgroup of low gradient aortic stenosis making an update of recommendations necessary. The document focuses in particular on the optimization of left ventricular outflow tract assessment, low flow, low gradient aortic stenosis with preserved ejection fraction, a new classification of aortic stenosis by gradient, flow and ejection fraction, and a grading algorithm for an integrated and stepwise approach of aortic stenosis assessment in clinical practice.
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Baumgartner et al. (2017) conducted a review in Aortic Valve Stenosis. Echocardiographic assessment guidelines was evaluated. Updated recommendations from EACVI and ASE provide a new classification and grading algorithm for echocardiographic assessment of aortic stenosis, focusing on low gradient subgroups.
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