January 2009

Valve stenosis is a common heart disorder and an important cause of cardiovascular morbidity and mortality. Echocardiography has become the key tool for the diagnosis and evaluation of valve disease, and is the primary non-invasive imaging method for valve stenosis assessment. Clinical decision-making is based on echocardiographic assessment of the severity of valve stenosis, so it is essential that standards be adopted to maintain accuracy and consistency across echocardiographic laboratories when assessing and reporting valve stenosis. The aim of this paper was to detail the recommended approach to the echocardiographic evaluation of valve stenosis, including recommendations for specific measures of stenosis severity, details of data acquisition and measurement, and grading of severity. These recommendations are based on the scientific literature and on the consensus of a panel of experts. IMPORTANT UPDATES: Since publication of the 2009 ASE Valve Stenosis Guideline, ASE endorsed the 2020 AHA/ACC Valvular Heart Disease Guidelines, released a 2017 Focused Update on Aortic Valve Stenosis and a 2023 Rheumatic Heart Disease guideline that contain focused updates on some of the information in this 2009 guideline. Please use the ASE 2023 RHD guideline and 2020 AHA/ACC document for descriptions and values of the stages of Mitral Stenosis (MS). The 2017 ASE Focused Update should be used for information on Aortic Valve Stenosis (AS). See links in Supplementary Materials below. NOTE: This guideline had a Corrigendum published 3/30/2009 at https://doi.org/10.1016/j.echo.2009.03.030 and a Correction published 2/22/2023 at https://doi.org/10.1016/j.echo.2023.02.005. Links included in Historical Documents below.