Aortic stenosis classification

Aortic Stenosis Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Claudia P. Hochberg, M.D. [2]; Abdul-Rahman Arabi, M.D. [3]; Keri Shafer, M.D. [4]; Priyamvada Singh, MBBS [5]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [6]

Overview

Aortic stenosis can be classified broadly in two main categories: acquired and congenital. Further classification can be applied based on the origin of the stenosis such as acquired rheumatic, congenital bicuspid, congenital subaortic, congenital subvalvular, and congenital supravalvular.

Classification

Acquired Aortic Stenosis

Adult acquired aortic stenosis has two major causes:

1. Calcific degenerative disease of a structurally normal trileaflet valve.

• Calcific aortic disease has many of the same risk factors as atherosclerotic disease and is characterized by fat deposition, inflammation, and calcification. It is also frequently observed among patients with renal failure.

2. Valve disease resulting from rheumatic fever.

• Rheumatic valve disease involves fusion of the commissures between the leaflets, with a small central orifice.

Congenital Left-Sided Outflow Obstruction

Congenital Left-Sided Outflow Obstruction can be due to a variety of conditions, all of which culminate in obstruction of the left ventricular outflow tract. These conditions include:

1. Malformation of the aortic valve such as a bicuspid aortic valve
2. Unicuspid valve
3. Hypoplasia of the annulus
4. Supravalvular stenosis
5. Subvalvular stenosis