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:
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