| TTE | TEE | fETT +/− echo | SPECT MPI | cMRI | Cardiac CT | Cath |
Aortic stenosis |
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Mild AS | 3 - 5 yrs | To clarify AoV structure or root pathology when needed. In select patients where TAVR being considered. | Severe AS where symptoms are unclear and to evaluate hemodynamic response & for TAVR | Where non critical stenosis and needed for evaluation of chest pain | Clarify valve bicuspid vs tricuspid valve when needed. Assist with evaluating severity of stenosis. Evaluation of RV for risk stratification as needed | As needed in select patients only. Related CT imaging for TAVR evaluation | Prior to planned surgery for evaluation of CAD. In select cases for evaluation of severity of AS |
Mod AS | 1 - 2 yrs | ||||||
Sev AS | ½ - 1 yr | ||||||
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Aortic regurg |
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Mild AR | 3 - 5 yrs | In severe AR and to clarify coexistent root pathology or valve structure as needed | Severe AI where symptoms are unclear | When needed for evaluation of chest pain | As needed for clarification of bicuspid vs tricuspid. As needed to follow chamber volumes and EF once severe | As needed in select patients only | Prior to planned surgery for evaluation of CAD |
Mod AR | 1 - 2 yrs | ||||||
Sev AR | ½ - 1 yr | ||||||
| *Every 3 months when dilated | ||||||
Mitral stenosis |
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Mild MS | 3 - 5 yrs | As needed in select patients | As needed to clarify symptoms and response to exercise | When needed for evaluation of chest pain | As needed in select patients only | As needed in select patient only | Prior to planned surgery for evaluation of CAD |
Mod MS | 1 - 2 yrs | ||||||
Sev MS | ½ - 1 yr | ||||||
Mitral regurg |
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Mild MR | 3 - 5 yrs | As needed in patient with moderate-severe regurgitation for definitive quantification and clarify structural etiology and assist with surgical planning | As needed when mod-sev to clarify symptoms and at times changes in pulmonary pressures | When needed for evaluation of chest pain | As needed for mod-severe regurgitation for evaluation of RV function and serial changes in LV function | As needed in select patients only | Prior to planned surgery for evaluation of CAD |
Mod MR | 1 - 2 yrs | ||||||
Sev MR | ½ - 1 yr | ||||||
| *Every 3 months when dilated | ||||||
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