17
Figure 3. Indications for AVR for Chronic AR
AR
Severe AR
(stages C and D)
• Vena contracta >0.6 cm
• Holodiastolic aortic flow reversal
• RVol ≥60 mL/beat
• RF ≥50%
• ERO ≥0.3 cm
2
• LV dilation
Progressive AR
(stage B)
• Vena contracta ≤0.6 cm
• RVol <60 mL/beat
• RF <50%
• ERO <0.3 cm
2
Symptomatic
(stage D)
Asymptomatic
(stage C)
Other cardiac
surgery
LVEF <50%
(stage D)
Other cardiac
surgery
LVEF ≥50%
LVESD >50 mm
(stage C2)
LVEF ≥50%
LVEDD >65 mm
Low surgical risk
LVEF ≥50%
LVESD ≤50 mm
LVEDD ≤65 mm
AVR
(IIb)
AVR
(IIa)
AVR
(I)
Periodic
Monitoring
AVR
(IIa)
NO
YES
