Treatment
Table 9. Stages of Valvular AS
Stage Definition Valve Anatomy
A At risk of AS • Bicuspid aortic valve (or other
congenital valve anomaly)
• Aortic valve sclerosis
B Progressive AS • Mild-to-moderate leaflet calcification
of a bicuspid or trileaflet valve with
some reduction in systolic motion or
• Rheumatic valve changes with
commissural fusion
C: Asymptomatic severe AS
C1 Asymptomatic severe AS Severe leaflet calcification or congenital
stenosis with severely reduced leaflet
opening
C2 Asymptomatic severe AS with LV
dysfunction
Severe leaflet calcification or congenital
stenosis with severely reduced leaflet
opening
D: Symptomatic severe AS
D1 Symptomatic severe high-
gradient AS
Severe leaflet calcification or congenital
stenosis with severely reduced leaflet
opening
D2 Symptomatic severe low-flow/low-
gradient AS with reduced LVEF
Severe leaflet calcification with severely
reduced leaflet motion
D3 Symptomatic severe low-gradient
AS with normal LVEF or
paradoxical low-flow severe AS
Severe leaflet calcification with severely
reduced leaflet motion
