When should we integrate CT calcium scoring into routine outpatient practice to arbitrate severity of aortic stenosis?

CT Aortic valve calcium scoring can be especially useful in cases of low flow/low gradient aortic stenosis or in cases where the severity of AS on echocardiography is equivocal. I don’t think there is a need for routine use in cases of unequivocal severe AS except perhaps in asymptomatic patients to assist in determining the timing of intervention, as even asymptomatic pts with severe AS and heavily calcified valves have a worse event-free survival and may benefit from AVR