Aortic Valve Stenosis Calculator

Perform online calculations to determine the Class of Recommendation for Aortic Valve Stenosis Intervention according to Guidelines

March 15th, 2022
(updated December 14th, 2024)

How to use the Calculator. The Calculator is an Excel file: type in the yellow cells the information requested, checking the Legend provided in or below the Calculator box for explanations concerning the variable values. The Calculator will instantly calculate the results of formulas in the gray cells, and provide the Flow Status, AS Grade, Severe AS Cathegory, Surgical Indication and Recommendation Class, and graphical description of LV Geometry.

The Calculator is based on the recently published 2021 European Guidelines for the management of valvular heart disease.

Legend

  • Sex
  • Experienced Center with HT
  • Symptoms
  • Indicators of adverse prognosis
  • Severe co-morbidities
  • Suitable for TAVI
  • QoL improves after surgery
  • Likely benefit from surgery
  • Concomitant open heart surgery
  • Exercise: symptoms
  • Exercise: BP fall > 20 mmHg
  • DSE flow reserve
  • Bicuspid AV
  • Severe AV calcium (CCT)
  • Markedly elevated BNP
  • Intact pericardium
  • Homograft bank
  • Male= 0 / Female= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1 / Sievers type 0= 2
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • No= 0 / Yes= 1
  • Indicators of adverse prognosis: Clinical: old age, atherosclerosis / Echocardio: AV calcium, Vmax, rate of hemodynamic progression, mean gradient increase > 20 mmHg with exercise, EF, severe LV Hypertrophy, low Stroke Volume index, Left atrial volume, LV GLS.
  • Likely benefit from surgery: Prolong survival > 1 year
  • Concomitant open heart surgery: CABG, other valve, ascending aorta
  • DSE flow reserve: 20% increase in stroke volume in response to low-dose dobutamine

Abbreviations

  • AV: Aortic Valve
  • BNP: B-type Natriuretic Peptide
  • BP: Blood Pressure
  • CCT: Cardiac Computed Tomography
  • CW: Continuous Wave Doppler
  • DSE: Dobutamine Stress Echocardiography
  • DVI: Dimensionless Index
  • EDD: End-diastolic diameter
  • EDHI: End-Diastolic Hypertrophy Index
  • EF: Ejection Fraction
  • EuroSCORE II: European System for Cardiac Operative Risk Evaluation (http://www.euroscore.org/calc.html)
  • GLS: Global Longitudinal Strain
  • HT: Heart Team
  • LV: Left Ventrixular
  • LVMI: LV Mass Index
  • LVOT: LV Outflow Tract
  • PD: Pulsed Doppler
  • QoL: Quality of Life
  • SAVR: Surgical Aortic Valve Replacement
  • STS-PROM: Society of Thoracic Surgeons Predicted Risk of Mortality (https://riskcalc.sts.org/stswebriskcalc/calculate)
  • TAVI: Transcatheter Aortic Valve Implantation
  • VTI: Velocity-Time Integral