Calcific
aortic stenosis is the most frequent valve disorder in the western world. It is a degenerative and chronic progressive disease in the elderly with increasing prevalence due to the demographic development in the population. As there is no medical
therapy, the only option in severe
aortic stenosis is valve replacement. Echocardiography is the diagnostic tool to assess
aortic stenosis severity and morphology of the valve.
Aortic stenosis is severe if the valve area is <1.0 cm(2), valve index <0.6 cm(2)/m(2) body surface, mean gradient >40 mmHg, and peak velocity >4.0 m/s. The entity of low flow, low gradient
aortic stenosis is complex, and diagnosis and
therapy are still challenging. Asymptomatic patients have a good prognosis, but must be reevaluated on a regular basis for the onset of symptoms or signs of progression. If one of the classical symptoms
dyspnea and
fatigue,
angina pectoris or
syncope occurs prognosis worsens dramatically and valve replacement is indicated. Gold standard
therapy for
aortic stenosis is
surgical valve replacement. For high-risk patients (older age and severe comorbidities),
transcatheter aortic valve implantation (TAVI) is established as standard
therapy.