Table 1.

EAPCI and VIVID definitions of structural valve deterioration

EAPCI definition of SVD (2017 Capodanno et al.)	VIVID definition of SVD (2018 Dvir et al.)
	SVD Stage 0 = no chance from immediate post-implant
Morphological SVD– •Leaflet integrity abnormality → torn/flail leaflet resulting in regurgitation •Leaflet structure abnormality → thickening/calcification causing stenosis/regurgitation •Leaflet function abnormality → impaired mobility causing stenosis/regurgitation •Strut/Frame abnormality	SVD Stage 1 = morphological leaflet abnormality w/o hemodynamic change. Visualized leaflet calcification, sclerosis, thickening or newfound motion dysfunction. Excludes infective endocarditis, valve thrombosis, isolated PPM without valvular deterioration, isolated PVL within SVD definition but these are included within Stage 1 definition as these bioprostheses can be prone to early SVD.
Moderate SVD → includes ANY of the following: •Mean gradient 20-40 mmHg •Mean gradient increases 10-20 mmHg from baseline •Moderate AR (>1+, <4+) new or worsened	SVD Stage 2S – moderate stenosis • Mean gradient 20-40 mmHg • Mean gradient increases 10-20 mmHg from baseline concomitant with dec. in EOA and DVI • Valve thrombosis ≠ SVD
	SVD Stage 2R – moderate regurgitation. • AR ≥2+/4+; if main component is PVL, do not consider as SVD
	SVD Stage 2RS – moderate stenosis AND regurgitation
Severe SVD → includes ANY of the following •Mean gradient ≥40 mmHg •Mean gradient ≥20 mmHg increase from baseline •Severe AR (>2+, 4+) new or worsened	SVD Stage 3 – severe stenosis and/or regurgitation • Mean gradient ≥40 mmHg • Mean gradient ≥20 mmHg increase from baseline concomitant with dec. in EOA and DVI • Severe AR (>2+, 4+) new or worsened
BVF – findings at autopsy of SVD → valve-related death •Repeat intervention following confirmed SVD •Severe hemodynamic SVD	Not defined

AR, aortic regurgitation; BVF, bioprosthetic valve failure; DVI, Doppler velocity index; EAPCI, European Association of Percutaneous Coronary Interventions; EOA, effective orifice area; PPM, patient-prosthesis mismatch; SVD, structural valve deterioration; VIVID, Valve In Valve International Database.