Aortic Stenosis Management (ESC/EACTS 2025)
Aortic Stenosis Management (ESC/EACTS 2025): Severe Aortic Stenosis → Symptomatic? → Intervention Recommended → Valve Selection - 2025 Update → TAVI Rec...
Interactive Decision Tree
Algorithm Steps
- ▶Start
Severe Aortic Stenosis
AVA <1.0 cm², Mean grad ≥40, Vmax ≥4.0 m/s
- ◆Decision
Symptomatic?
Dyspnea, angina, syncope
If Yes:
- ●Action
Intervention Recommended
Class I for symptomatic severe AS
- ◆Decision
Valve Selection - 2025 Update
Age and anatomy assessment
- ●Action
TAVI Recommended
Age ≥70 + Tricuspid AV + TF access
- 2025 Update: Age lowered from 75 to 70
- Class I, LOE A
- Evidence: DEDICATE, NOTION-2
- ●Action
Heart Team Decision
Individualized factors
- Life expectancy
- Comorbidities
- Anatomy
- Local expertise
- Lifetime trajectory
- ✓Outcome
Intervention Performed
Follow-up per guidelines
- ●Action
SAVR Recommended
Age <70 OR Bicuspid OR Non-TF
- Bicuspid: TAVI only Class IIb
- Young patients: durability concerns
- Concomitant surgery needed
If No:
- ●Action
Asymptomatic - Assess Risk
Consider intervention if:
- Very severe (Vmax ≥5 m/s)
- LVEF <55%
- Low surgical risk
- BNP elevation
- Rapid progression
Guideline Source
2025 ESC/EACTS Guidelines for Valvular Heart Disease
Clinical Safety Information
Clinical Decision Support — Not a Substitute for Clinical Judgment
Individual patient factors may require deviation from these recommendations.
Known Limitations
- Age cutoffs are guides, not absolute
- Bicuspid AS has different considerations
- Heart Team decision always required
Contraindicated Populations
Applicable Regions
EU: ESC/EACTS 2025: TAVI age ≥70 (lowered from 75)
US: ACC/AHA Heart Team approach
Next steps
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Related Resources
Frequently Asked Questions
What is the Aortic Stenosis Management (ESC/EACTS 2025)?
The Aortic Stenosis Management (ESC/EACTS 2025) is a management clinical algorithm for Cardiology. It provides a structured decision tree to guide clinical decision-making, based on 2025 ESC/EACTS Guidelines for Valvular Heart Disease.
What guideline is the Aortic Stenosis Management (ESC/EACTS 2025) based on?
This algorithm is based on 2025 ESC/EACTS Guidelines for Valvular Heart Disease (DOI: 10.1093/eurheartj/ehab395).
What are the limitations of the Aortic Stenosis Management (ESC/EACTS 2025)?
Known limitations include: Age cutoffs are guides, not absolute; Bicuspid AS has different considerations; Heart Team decision always required. Individual patient factors may require deviation from these recommendations.
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