0411 : Aortic valve is less severely affected in paradoxical low gradient than in high gradient severe aortic stenosis

Low-Gradient Aortic Valve Stenosis

Accreditation and Designation Statement The American College of Cardiology Foundation (ACCF) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The ACCF designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the exten...

High- Versus Low-Gradient 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...

Natural history of paradoxical low-gradient severe aortic stenosis.

BACKGROUND Up to 30% of patients with severe aortic stenosis (SAS; indexed aortic valve area <0.6 cm(2)/m(2)) present with low transvalvular gradient despite a normal left ventricular ejection fraction. Presently, there is intense controversy as to the prognostic implications of such findings. Accordingly, the aim of the present work was to compare the natural history of patients with paradoxic...

Low-gradient aortic stenosis

Low-gradient aortic stenosis (AS) has been a vexing problem for cardiologists since its original description in 1980 by Carabello et al.1 In that study, 3 of 4 patients with low-gradient AS died at surgery, and the other patient had persistent severe heart failure postoperatively. Subsequent studies showed that although operative mortality is high, most patients survive aortic valve replacement...