How are you taking part in this consultation?

You will not be able to change how you comment later.

You must be signed in to answer questions

    The content on this page is not current guidance and is only for the purposes of the consultation process.

    Interventional procedure overview of aortic valve reconstruction using glutaraldehyde-treated autologous pericardium for aortic valve disease

    Closed for comments This consultation ended on at   Request commenting lead permission

    Outcome measures

    The main outcomes included survival rates, reoperation rates, mortality and resolution of clinical symptoms or improvement in biochemical parameters, such as aortic valve pressure gradient and aortic valve function. Other outcomes included technical failure, cardiopulmonary bypass time, aortic cross-clamp time, length of intensive care unit stay, cusp calcification rates, in-hospital events and the risk of endocarditis. The measures used are detailed in the following paragraphs.

    New York Heart Association (NYHA) heart failure classification

     Class

    Symptoms

    I

    Cardiac disease, but no symptoms and no limitation in ordinary physical activity, for example no shortness of breath when walking, climbing stairs etc.

    II

    Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity.

    III

    Marked limitation in activity because of symptoms, even during less-than-ordinary activity, for example walking short distances (20–100 m).
    Comfortable only at rest.

    IV

    Severe limitations. Experiences symptoms even while at rest. Mostly bedbound patients.

    Recommendations for classification of aortic stenosis, European Society of Cardiology (ESC) and American Society of Echocardiography(ASE)

     Severity

    Aortic sclerosis 

    Mild 

    Moderate 

    Severe 

    Aortic jet velocity (m/s) 

    ≤2.5 m/s 

    2.6–2.9 

    3.0–4.0 

    >4.0 

    Mean gradient (mmHg) 

    — 

    <20 (<30ESC)  

    20–40ASE (30–50ESC)  

    >40ASE (>50ESC)  

    Aortic valve area (AVA, cm2)  

    — 

    >1.5 

    1.0–1.5 

    <1.0 

    Indexed AVA (cm2/m2)  

     

    >0.85 

    0.60–0.85 

    <0.6 

    Velocity ratio 

     

    >0.50 

    0.25–0.50 

    <0.25 

    Classifications for aortic regurgitation of the British Society of Echocardiography

    Severity

    Mild

    Moderate

    Severe

    Vena contracta width (cm)

    <0.3

    >0.6

    Jet width/left ventricle outflow tract (LVOT) diameter (%)

    <25

    ≥65

    Regurgitant volume (ml/beat)

    <30

    31–59

    ≥60

    Regurgitant fraction (%)

    <30

    31–49

    ≥50

    Regurgitant orifice area (cm2)

    <0.1

    0.11–0.29

    ≥0.3

    Velocity time integral (VTI) diastolic flow reversal (upper descending aorta, cm)

    15

    Pressure half time (ms)

    >500

    <250