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IA chronique sévère symptomatiqueIA chronique sévère asymptomatique +o FEVG£50%o Dilatation VG : diamètre télésystolique > 50 mm ou > 25 mm2 et/ou DTDVG > 70 mm o Bas risque + diamètre télésystolique > 20 mm2 ou FEVG ≤ 55%o Chirurgie cardiaque pour une autre indicationIA aigue sévère : URGENTEndocardite infectieuseRemplacement de l'aorte ascendante si : (Valve + aorte = Bentall)o 3 55mm patients normauxo 3 50mm si Marfan ou bicuspidie à haut risque de dissection o 3 45mm si Marfan + FDR de rupture

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