Grading of Aortic Valve Stenosis

Aortic valve stenosis is primarily categorized based on the aortic valve orifice area or the degree of transvalvular pressure gradient. This classification helps physicians assess the severity of the condition and determine the appropriate course of treatment. The following outlines the standard grading system used in clinical practice:

Grading by Aortic Valve Orifice Area

The normal surface area of the aortic valve typically ranges between 3.0 and 4.0 cm². When stenosis occurs, the size of the valve opening decreases, which can be measured and classified accordingly:

• Mild Stenosis: Valve area remains greater than 1.5 cm².
• Moderate Stenosis: Valve area narrows to between 1.0 and 1.5 cm².
• Severe Stenosis: Valve area falls below 1.0 cm².

Grading by Transvalvular Pressure Gradient

In addition to valve area, the pressure difference across the aortic valve—known as the transvalvular gradient—also serves as a key indicator of stenosis severity:

• Mild Stenosis: Pressure gradient remains under 30 mmHg.
• Moderate Stenosis: Gradient increases to between 30 and 50 mmHg.
• Severe Stenosis: Gradient exceeds 50 mmHg.

Summary and Clinical Implications

In summary, aortic valve stenosis can be classified into three stages—mild, moderate, and severe—based on either the valve orifice area or the transvalvular pressure gradient. Mild cases often require monitoring without immediate intervention, while moderate to severe cases may necessitate further diagnostic testing and potential surgical or interventional treatment. Patients with moderate to severe stenosis, especially those experiencing symptoms or meeting surgical criteria, should consider consulting a cardiac specialist to explore treatment options such as valve replacement or repair.