ACC/AATS/AHA/ASE/EACTS/HVS/SCA/SCAI/SCCT/SCMR/STS 2017 Appropriate use criteria for the treatment of patients with severe aortic stenosis: A report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, European Association for Cardio-Thoracic Surgery, Heart Valve Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons

Robert O. Bonow, Alan S. Brown, Linda D. Gillam, Samir R. Kapadia, Clifford J. Kavinsky, Brian R. Lindman, Michael J. Mack, Vinod H. Thourani, Gregory J. Dehmer, Thomas M. Beaver, Steven M. Bradley, Blase A. Carabello, Milind Y. Desai, Isaac George, Philip Green, David R. Holmes, Douglas Johnston, Jonathon Leipsic, Stephanie L. Mick, Jonathan J. Passeri & 22 others Robert N. Piana, Nathaniel Reichek, Carlos E. Ruiz, Cynthia C. Taub, James D. Thomas, Zoltan G. Turi, John U. Doherty, Steven R. Bailey, Nicole M. Bhave, Stacie L. Daugherty, Larry S. Dean, Claire S. Duvernoy, Robert C. Hendel, Christopher M. Kramer, Bruce D. Lindsay, Warren J. Manning, Praveen Mehrotra, Manesh R. Patel, Ritu Sachdeva, L. Samuel Wann, David E. Winchester, Joseph M. Allen

Research output: Contribution to journalArticle

Abstract

The American College of Cardiology collaborated with the American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, European Association for Cardio-Thoracic Surgery, Heart Valve Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons to develop and evaluate Appropriate Use Criteria (AUC) for the treatment of patients with severe aortic stenosis (AS). This is the first AUC to address the topic of AS and its treatment options, including surgical aortic valve replacement and transcatheter aortic valve replacement. A number of common patient scenarios experienced in daily practice were developed along with assumptions and definitions for those scenarios, which were all created using guidelines, clinical trial data and expert opinion in the field of AS. The '2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines' [1] and its 2017 focused update paper [2] were used as the primary guiding references in developing these indications. The Writing Group identified 95 clinical scenarios based on patient symptoms and clinical presentation, and up to 6 potential treatment options for those patients. A separate, independent Rating Panel was asked to score each indication from 1 to 9, with 1-3 categorized as 'Rarely Appropriate', 4-6 as 'May Be Appropriate' and 7-9 as 'Appropriate'. After considering factors such as symptom status, left ventricular function, surgical risk, and the presence of concomitant coronary or other valve disease, the Rating Panel determined that either surgical aortic valve replacement or transcatheter aortic valve replacement is appropriate in most patients with symptomatic AS at intermediate or high surgical risk; however, situations commonly arise in clinical practice in which the indications for surgical aortic valve replacement or transcatheter aortic valve replacement are less clear, including situations in which one form of valve replacement would appear reasonable when the other is less so, as do other circumstances in which neither intervention is the suitable treatment option. The purpose of this AUC is to provide guidance to clinicians in the care of patients with severe AS by identifying the reasonable treatment and intervention options available based on the myriad clinical scenarios with which patients present. This AUC document also serves as an educational and quality improvement tool to identify patterns of care and reduce the number of rarely appropriate interventions in clinical practice.

LanguageEnglish (US)
Article numberezx410
Pages306-308
Number of pages3
JournalEuropean Journal of Cardio-thoracic Surgery
Volume53
Issue number2
DOIs
StatePublished - Feb 1 2018
Externally publishedYes

Fingerprint

Heart Valves
Aortic Valve Stenosis
Advisory Committees
Tomography
Aortic Valve
Surgical Instruments
Therapeutics
Guidelines
Heart Valve Diseases
Expert Testimony
Quality Improvement
Left Ventricular Function
Practice Guidelines
Patient Care
Clinical Trials
Transcatheter Aortic Valve Replacement

Keywords

  • ACC Appropriate Use Criteria
  • Balloon aortic valvuloplasty
  • Severe aortic stenosis
  • Surgical aortic valve replacement
  • Transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

ACC/AATS/AHA/ASE/EACTS/HVS/SCA/SCAI/SCCT/SCMR/STS 2017 Appropriate use criteria for the treatment of patients with severe aortic stenosis : A report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, European Association for Cardio-Thoracic Surgery, Heart Valve Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. / Bonow, Robert O.; Brown, Alan S.; Gillam, Linda D.; Kapadia, Samir R.; Kavinsky, Clifford J.; Lindman, Brian R.; Mack, Michael J.; Thourani, Vinod H.; Dehmer, Gregory J.; Beaver, Thomas M.; Bradley, Steven M.; Carabello, Blase A.; Desai, Milind Y.; George, Isaac; Green, Philip; Holmes, David R.; Johnston, Douglas; Leipsic, Jonathon; Mick, Stephanie L.; Passeri, Jonathan J.; Piana, Robert N.; Reichek, Nathaniel; Ruiz, Carlos E.; Taub, Cynthia C.; Thomas, James D.; Turi, Zoltan G.; Doherty, John U.; Bailey, Steven R.; Bhave, Nicole M.; Daugherty, Stacie L.; Dean, Larry S.; Duvernoy, Claire S.; Hendel, Robert C.; Kramer, Christopher M.; Lindsay, Bruce D.; Manning, Warren J.; Mehrotra, Praveen; Patel, Manesh R.; Sachdeva, Ritu; Wann, L. Samuel; Winchester, David E.; Allen, Joseph M.

In: European Journal of Cardio-thoracic Surgery, Vol. 53, No. 2, ezx410, 01.02.2018, p. 306-308.

Research output: Contribution to journalArticle

Bonow, RO, Brown, AS, Gillam, LD, Kapadia, SR, Kavinsky, CJ, Lindman, BR, Mack, MJ, Thourani, VH, Dehmer, GJ, Beaver, TM, Bradley, SM, Carabello, BA, Desai, MY, George, I, Green, P, Holmes, DR, Johnston, D, Leipsic, J, Mick, SL, Passeri, JJ, Piana, RN, Reichek, N, Ruiz, CE, Taub, CC, Thomas, JD, Turi, ZG, Doherty, JU, Bailey, SR, Bhave, NM, Daugherty, SL, Dean, LS, Duvernoy, CS, Hendel, RC, Kramer, CM, Lindsay, BD, Manning, WJ, Mehrotra, P, Patel, MR, Sachdeva, R, Wann, LS, Winchester, DE & Allen, JM 2018, 'ACC/AATS/AHA/ASE/EACTS/HVS/SCA/SCAI/SCCT/SCMR/STS 2017 Appropriate use criteria for the treatment of patients with severe aortic stenosis: A report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, European Association for Cardio-Thoracic Surgery, Heart Valve Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons' European Journal of Cardio-thoracic Surgery, vol. 53, no. 2, ezx410, pp. 306-308. https://doi.org/10.1093/ejcts/ezx389
Bonow, Robert O. ; Brown, Alan S. ; Gillam, Linda D. ; Kapadia, Samir R. ; Kavinsky, Clifford J. ; Lindman, Brian R. ; Mack, Michael J. ; Thourani, Vinod H. ; Dehmer, Gregory J. ; Beaver, Thomas M. ; Bradley, Steven M. ; Carabello, Blase A. ; Desai, Milind Y. ; George, Isaac ; Green, Philip ; Holmes, David R. ; Johnston, Douglas ; Leipsic, Jonathon ; Mick, Stephanie L. ; Passeri, Jonathan J. ; Piana, Robert N. ; Reichek, Nathaniel ; Ruiz, Carlos E. ; Taub, Cynthia C. ; Thomas, James D. ; Turi, Zoltan G. ; Doherty, John U. ; Bailey, Steven R. ; Bhave, Nicole M. ; Daugherty, Stacie L. ; Dean, Larry S. ; Duvernoy, Claire S. ; Hendel, Robert C. ; Kramer, Christopher M. ; Lindsay, Bruce D. ; Manning, Warren J. ; Mehrotra, Praveen ; Patel, Manesh R. ; Sachdeva, Ritu ; Wann, L. Samuel ; Winchester, David E. ; Allen, Joseph M. / ACC/AATS/AHA/ASE/EACTS/HVS/SCA/SCAI/SCCT/SCMR/STS 2017 Appropriate use criteria for the treatment of patients with severe aortic stenosis : A report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, European Association for Cardio-Thoracic Surgery, Heart Valve Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. In: European Journal of Cardio-thoracic Surgery. 2018 ; Vol. 53, No. 2. pp. 306-308.
@article{9e6af2bb635243ecaeb77f199e580623,
title = "ACC/AATS/AHA/ASE/EACTS/HVS/SCA/SCAI/SCCT/SCMR/STS 2017 Appropriate use criteria for the treatment of patients with severe aortic stenosis: A report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, European Association for Cardio-Thoracic Surgery, Heart Valve Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons",
abstract = "The American College of Cardiology collaborated with the American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, European Association for Cardio-Thoracic Surgery, Heart Valve Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons to develop and evaluate Appropriate Use Criteria (AUC) for the treatment of patients with severe aortic stenosis (AS). This is the first AUC to address the topic of AS and its treatment options, including surgical aortic valve replacement and transcatheter aortic valve replacement. A number of common patient scenarios experienced in daily practice were developed along with assumptions and definitions for those scenarios, which were all created using guidelines, clinical trial data and expert opinion in the field of AS. The '2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines' [1] and its 2017 focused update paper [2] were used as the primary guiding references in developing these indications. The Writing Group identified 95 clinical scenarios based on patient symptoms and clinical presentation, and up to 6 potential treatment options for those patients. A separate, independent Rating Panel was asked to score each indication from 1 to 9, with 1-3 categorized as 'Rarely Appropriate', 4-6 as 'May Be Appropriate' and 7-9 as 'Appropriate'. After considering factors such as symptom status, left ventricular function, surgical risk, and the presence of concomitant coronary or other valve disease, the Rating Panel determined that either surgical aortic valve replacement or transcatheter aortic valve replacement is appropriate in most patients with symptomatic AS at intermediate or high surgical risk; however, situations commonly arise in clinical practice in which the indications for surgical aortic valve replacement or transcatheter aortic valve replacement are less clear, including situations in which one form of valve replacement would appear reasonable when the other is less so, as do other circumstances in which neither intervention is the suitable treatment option. The purpose of this AUC is to provide guidance to clinicians in the care of patients with severe AS by identifying the reasonable treatment and intervention options available based on the myriad clinical scenarios with which patients present. This AUC document also serves as an educational and quality improvement tool to identify patterns of care and reduce the number of rarely appropriate interventions in clinical practice.",
keywords = "ACC Appropriate Use Criteria, Balloon aortic valvuloplasty, Severe aortic stenosis, Surgical aortic valve replacement, Transcatheter aortic valve replacement",
author = "Bonow, {Robert O.} and Brown, {Alan S.} and Gillam, {Linda D.} and Kapadia, {Samir R.} and Kavinsky, {Clifford J.} and Lindman, {Brian R.} and Mack, {Michael J.} and Thourani, {Vinod H.} and Dehmer, {Gregory J.} and Beaver, {Thomas M.} and Bradley, {Steven M.} and Carabello, {Blase A.} and Desai, {Milind Y.} and Isaac George and Philip Green and Holmes, {David R.} and Douglas Johnston and Jonathon Leipsic and Mick, {Stephanie L.} and Passeri, {Jonathan J.} and Piana, {Robert N.} and Nathaniel Reichek and Ruiz, {Carlos E.} and Taub, {Cynthia C.} and Thomas, {James D.} and Turi, {Zoltan G.} and Doherty, {John U.} and Bailey, {Steven R.} and Bhave, {Nicole M.} and Daugherty, {Stacie L.} and Dean, {Larry S.} and Duvernoy, {Claire S.} and Hendel, {Robert C.} and Kramer, {Christopher M.} and Lindsay, {Bruce D.} and Manning, {Warren J.} and Praveen Mehrotra and Patel, {Manesh R.} and Ritu Sachdeva and Wann, {L. Samuel} and Winchester, {David E.} and Allen, {Joseph M.}",
year = "2018",
month = "2",
day = "1",
doi = "10.1093/ejcts/ezx389",
language = "English (US)",
volume = "53",
pages = "306--308",
journal = "European Journal of Cardio-thoracic Surgery",
issn = "1010-7940",
publisher = "Elsevier",
number = "2",

}

TY - JOUR

T1 - ACC/AATS/AHA/ASE/EACTS/HVS/SCA/SCAI/SCCT/SCMR/STS 2017 Appropriate use criteria for the treatment of patients with severe aortic stenosis

T2 - European Journal of Cardio-thoracic Surgery

AU - Bonow, Robert O.

AU - Brown, Alan S.

AU - Gillam, Linda D.

AU - Kapadia, Samir R.

AU - Kavinsky, Clifford J.

AU - Lindman, Brian R.

AU - Mack, Michael J.

AU - Thourani, Vinod H.

AU - Dehmer, Gregory J.

AU - Beaver, Thomas M.

AU - Bradley, Steven M.

AU - Carabello, Blase A.

AU - Desai, Milind Y.

AU - George, Isaac

AU - Green, Philip

AU - Holmes, David R.

AU - Johnston, Douglas

AU - Leipsic, Jonathon

AU - Mick, Stephanie L.

AU - Passeri, Jonathan J.

AU - Piana, Robert N.

AU - Reichek, Nathaniel

AU - Ruiz, Carlos E.

AU - Taub, Cynthia C.

AU - Thomas, James D.

AU - Turi, Zoltan G.

AU - Doherty, John U.

AU - Bailey, Steven R.

AU - Bhave, Nicole M.

AU - Daugherty, Stacie L.

AU - Dean, Larry S.

AU - Duvernoy, Claire S.

AU - Hendel, Robert C.

AU - Kramer, Christopher M.

AU - Lindsay, Bruce D.

AU - Manning, Warren J.

AU - Mehrotra, Praveen

AU - Patel, Manesh R.

AU - Sachdeva, Ritu

AU - Wann, L. Samuel

AU - Winchester, David E.

AU - Allen, Joseph M.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - The American College of Cardiology collaborated with the American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, European Association for Cardio-Thoracic Surgery, Heart Valve Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons to develop and evaluate Appropriate Use Criteria (AUC) for the treatment of patients with severe aortic stenosis (AS). This is the first AUC to address the topic of AS and its treatment options, including surgical aortic valve replacement and transcatheter aortic valve replacement. A number of common patient scenarios experienced in daily practice were developed along with assumptions and definitions for those scenarios, which were all created using guidelines, clinical trial data and expert opinion in the field of AS. The '2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines' [1] and its 2017 focused update paper [2] were used as the primary guiding references in developing these indications. The Writing Group identified 95 clinical scenarios based on patient symptoms and clinical presentation, and up to 6 potential treatment options for those patients. A separate, independent Rating Panel was asked to score each indication from 1 to 9, with 1-3 categorized as 'Rarely Appropriate', 4-6 as 'May Be Appropriate' and 7-9 as 'Appropriate'. After considering factors such as symptom status, left ventricular function, surgical risk, and the presence of concomitant coronary or other valve disease, the Rating Panel determined that either surgical aortic valve replacement or transcatheter aortic valve replacement is appropriate in most patients with symptomatic AS at intermediate or high surgical risk; however, situations commonly arise in clinical practice in which the indications for surgical aortic valve replacement or transcatheter aortic valve replacement are less clear, including situations in which one form of valve replacement would appear reasonable when the other is less so, as do other circumstances in which neither intervention is the suitable treatment option. The purpose of this AUC is to provide guidance to clinicians in the care of patients with severe AS by identifying the reasonable treatment and intervention options available based on the myriad clinical scenarios with which patients present. This AUC document also serves as an educational and quality improvement tool to identify patterns of care and reduce the number of rarely appropriate interventions in clinical practice.

AB - The American College of Cardiology collaborated with the American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, European Association for Cardio-Thoracic Surgery, Heart Valve Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons to develop and evaluate Appropriate Use Criteria (AUC) for the treatment of patients with severe aortic stenosis (AS). This is the first AUC to address the topic of AS and its treatment options, including surgical aortic valve replacement and transcatheter aortic valve replacement. A number of common patient scenarios experienced in daily practice were developed along with assumptions and definitions for those scenarios, which were all created using guidelines, clinical trial data and expert opinion in the field of AS. The '2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines' [1] and its 2017 focused update paper [2] were used as the primary guiding references in developing these indications. The Writing Group identified 95 clinical scenarios based on patient symptoms and clinical presentation, and up to 6 potential treatment options for those patients. A separate, independent Rating Panel was asked to score each indication from 1 to 9, with 1-3 categorized as 'Rarely Appropriate', 4-6 as 'May Be Appropriate' and 7-9 as 'Appropriate'. After considering factors such as symptom status, left ventricular function, surgical risk, and the presence of concomitant coronary or other valve disease, the Rating Panel determined that either surgical aortic valve replacement or transcatheter aortic valve replacement is appropriate in most patients with symptomatic AS at intermediate or high surgical risk; however, situations commonly arise in clinical practice in which the indications for surgical aortic valve replacement or transcatheter aortic valve replacement are less clear, including situations in which one form of valve replacement would appear reasonable when the other is less so, as do other circumstances in which neither intervention is the suitable treatment option. The purpose of this AUC is to provide guidance to clinicians in the care of patients with severe AS by identifying the reasonable treatment and intervention options available based on the myriad clinical scenarios with which patients present. This AUC document also serves as an educational and quality improvement tool to identify patterns of care and reduce the number of rarely appropriate interventions in clinical practice.

KW - ACC Appropriate Use Criteria

KW - Balloon aortic valvuloplasty

KW - Severe aortic stenosis

KW - Surgical aortic valve replacement

KW - Transcatheter aortic valve replacement

UR - http://www.scopus.com/inward/record.url?scp=85041498750&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85041498750&partnerID=8YFLogxK

U2 - 10.1093/ejcts/ezx389

DO - 10.1093/ejcts/ezx389

M3 - Article

VL - 53

SP - 306

EP - 308

JO - European Journal of Cardio-thoracic Surgery

JF - European Journal of Cardio-thoracic Surgery

SN - 1010-7940

IS - 2

M1 - ezx410

ER -