Table 1. Current Treatment Recommendations for Patients
with Aortic Stenosis (continued)
Treatment
Indication
Medical Therapy
• There is no specific therapy for • Hemodynamic instability
asymptomatic AS
• Medical therapy is not indicated
for symptomatic severe AS
• Appropriate control of blood
pressure and other risk factors as
indicated
• Statins are NOT indicated for
preventing progression of AS
• Diuretics, vasodilators and
positive inotropes should be
avoided in patients awaiting
surgery because of risk of
destabilization
Major Complications
The original PARTNER protocol specified inclusion criteria as a minimum STS-predicted risk of
mortality of ≥10. During the trial enrollment phase, the minimum STS-predicted risk of mortality was
changed to ≥8. In both instances, 2 surgeons had to document that the true predicted risk of mortality
was ≥15.
b
CoreValve is investigational only.
a
Evidence Grades
Class I: Conditions for which there is evidence for and/or general agreement that the procedure or
treatment is beneficial, useful, and effective
Class II: Conditions for which there is conflicting evidence and/or a divergence of opinion about the
usefulness/efficacy of a procedure or treatment
Class IIa: Weight of evidence/opinion is in favor of usefulness/efficacy
Class IIb: Usefulness/efficacy is less well established by evidence/opinion
Level of Evidence A: Data derived from multiple randomized clinical trials or meta-analyses
Level of Evidence B: Data derived from a single randomized trial or nonrandomized studies
Level of Evidence C: Only consensus opinion of experts, case studies, or standard-of-care.
