Low-Flow Severe Aortic Stenosis

Paradoxical Low-Flow, Low-Gradient Aortic Stenosis

Low-flow, low-gradient aortic stenosis (AS) is a highly challenging condition in terms of diagnosis and therapeutic management. The transvalvular pressure gradient is inversely related to the square of aortic valve area (AVA) and directly related to the square of flow. Hence, a patient with severe AS may nonetheless present with a low gradient if his or her left ventricular (LV) output is reduc...

Low "gradient", low flow aortic stenosis.

Correspondence to: Dr John Chambers, Cardiothoracic Centre, St Thomas Hospital, London SE1 7EH, UK; jboydchambers@ aol.com _________________________ A ortic stenosis is thought to have a long, asymptomatic latent phase during which the risk of sudden death is low. In fact symptoms can be revealed by treadmill exercise in a large proportion of apparently asymptomatic patients. Patients may limit...

High- Versus Low-Gradient Severe Aortic Stenosis

Role of Transesophageal Echocardiography in the Diagnosis of Paradoxical Low Flow, Low Gradient Severe Aortic Stenosis

BACKGROUND AND OBJECTIVES Prior studies indicate that up to 35% of cases of severe aortic stenosis (AS) have paradoxical low flow, low gradient despite preserved left ventricular ejection fraction (LVEF). However, error in left ventricular outflow tract (LVOT) diameter may lead to misclassification. Herein, we determined whether measurement of LVOT diameter by transesophageal echocardiography (...

Clinical presentation and outcomes after transcatheter aortic valve implantation in patients with low flow/low gradient severe aortic stenosis.

OBJECTIVES To identify predictors of mortality, functional status, and hemodynamical changes of patients undergoing transcatheter aortic valve implantation (TAVI) for low flow/low gradient aortic stenosis (LF/LG AS). BACKGROUND There is little published data regarding the outcomes of patients with LF/LG AS following TAVI. METHODS Sixty-eight patients with severe AS, left ventricular dysfunc...