Aortic stenosis classification

Resident Survival Guide

Aortic Stenosis Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mandana Chitsazan, M.D. [2]Priyamvada Singh, MBBS [3]; Kristin Feeney, B.S. [4]; Usama Talib, BSc, MD [5]

Overview

Aortic stenosis can be classified broadly in two main categories: acquired and congenital. Further classification according to the origin of the stenosis includes acquired calcification, acquired rheumatic disease, congenital bicuspid valve, congenital unicuspid valve, congenital hypoplasia of the annulus, congenital subaortic, congenital subvalvular, and congenital supravalvular.

Classification

Aortic stenosis may be classified into two main categories:

• Acquired

• Congenital

Stage	Definition	Valve Anatomy	Valve Hemodynamics	Hemodynamic Consequences	Symptoms
A	At risk of AS	Bicuspid aortic valve (or other congenital valvular anomalies) Aortic valve sclerosis	Aortic Vmax <2 m/s	None	None
B	Progressive AS	Mild to moderate leaflet calcification of a bicuspid or trileaflet valve with some reduction in systolic motion or Rhematic valve changes with commissural fusion	Mild AS: Aortic Vmax 2.0-2.9 m/s or mean ΔP <20 mmHg Moderate AS: Aortic Vmax 3.0-3.9 m/s or mean ΔP 20-39 mmHg	Early LV diastolic dysfunction may be present Normal LVEF	None
C
C1
C2
D
D1
D2
D3