Aortic Valve Area and Aortic Valve Index
by Andrew Kupersmith, MD
Aortic Valve Area Definition
Aortic-valve area (AVA) refers to the maximal opening of the aortic valve. The AVA is used to determine the severity of aortic-valve stenosis.
AVA can be measured invasively during cardiac catheterization using the Gorlin equation or noninvasively using echocardiography.
An AVA measuring > 2 cm2 is normal, of 1.5-1.9 cm2 suggests mild aortic stenosis, of 1.0-1.5 cm2 suggests moderate aortic stenosis, and < 1.0 cm2 suggests severe aortic stenosis.
Aortic Valve Area Index Definition
The aortic valve area index (AVAI) is calculated to differentiate between different degrees of aortic stenosis in patients with varied body sizes. The calculation involves dividing the aortic valve area by the body surface area.
Definition of severe aortic valve area is < 1.0 cm2 and, when indexed, <0.6 cm2/m2. Use of this index significantly increases the proportion of patients who meet criteria for severe stenosis by including patients with a milder degree of the disease without improving the predictive accuracy for events related to the aortic valve. Asymptomatic patients having an AVAI > 0.6 cm2/m2 along with a peak aortic jet velocity of < 4.0 m/s have an excellent prognosis.
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Jander N, Gohlke-Bärwolf C, Bahlmann E, et al. Indexing aortic valve area by body surface area increases the prevalence of severe aortic stenosis. Heart. 2014;100:28–33.
Saito T, Muro T, Takeda H, Prognostic value of aortic valve area index in asymptomatic patients with severe aortic stenosis. Am J Cardiol. 2012;110:93-97.