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In this study, we examined the preoperative clinical and cardiac CT findings of different subtypes of AS in patients with surgical\u00a0aortic valve replacement\u00a0(AVR) and evaluated the subtype classification as a factor affecting post-surgical outcomes. This study included 511 (66.9\u2009\u00b1\u20098.8\u00a0years, 55% men) consecutive patients with severe AS who underwent surgical AVR. Aortic valve area (AVA) was obtained by echocardiography (AVA<jats:sub>echo<\/jats:sub>) and by CT (AVA<jats:sub>CT<\/jats:sub>) using each modalities measurement of the left ventricular outflow tract. Patients with AS were classified as (1) high-gradient severe (n\u2009=\u2009438), (2) classic LF-LG (n\u2009=\u200918), and (3) paradoxical LF-LG (n\u2009=\u200955) based on echocardiography. In all patients, 455 (89.0%) patients were categorized as severe AS according to the AVA<jats:sub>CT<\/jats:sub>. However, 56 patients were re-classified as moderate AS (43 [9.8%] high-gradient severe AS, 5 [27.8%] classic LF-LG AS, and 8 [14.5%] paradoxical LF-LG AS) by AVA<jats:sub>CT<\/jats:sub>. The classic LF-LG AS group presented larger AVA<jats:sub>CT<\/jats:sub> and aortic annulus than those in high-gradient severe AS group and one third of them had AVA<jats:sub>CT<\/jats:sub>\u2009\u2265\u20091.2\u00a0cm<jats:sup>2<\/jats:sup>. After multivariable adjustment, old age (hazard ratio [HR], 1.04, P\u2009=\u20090.049), high B-type natriuretic peptide (BNP) (HR, 1.005; P\u2009&lt;\u20090.001), preoperative atrial fibrillation (HR, 2.75; P\u2009=\u20090.003), classic LF-LG AS (HR, 5.53, P\u2009=\u20090.004), and small aortic annulus on CT\u00a0(HR, 0.57; P\u2009=\u20090.002) were independently associated with major adverse cardiac and cerebrovascular events (MACCE) after surgical AVR.<\/jats:p>","DOI":"10.1038\/s41598-022-11491-3","type":"journal-article","created":{"date-parts":[[2022,5,7]],"date-time":"2022-05-07T10:05:04Z","timestamp":1651917904000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Classification of severe aortic stenosis and outcomes after aortic valve replacement"],"prefix":"10.1038","volume":"12","author":[{"given":"Yura","family":"Ahn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se Jin","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soyeoun","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon Bum","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong-Min","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duk-Hyun","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Kwan","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hwa Jung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon-Won","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Hyun","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dae-Hee","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Jung","family":"Koo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,7]]},"reference":[{"key":"11491_CR1","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1161\/CIRCIMAGING.111.967554","volume":"5","author":"J Adda","year":"2012","unstructured":"Adda, J. et al. 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