Low-Gradient “Severe” Aortic Stenosis With Normal Systolic Function

Low gradient severe aortic stenosis with normal ejection fraction.

Sir, A 18 year old female patient was diagnosed to have tubercular cervical lymphadenopathy and started on antitubercular therapy (ATT). The lymphadenopathy regressed, however, after four months of ATT, patient developed jaundice, abdominal distension and swelling of bilateral lower limbs. She had no bleeding manifestation or altered behaviour. She had no history of jaundice in the past, histor...

High- Versus Low-Gradient Severe Aortic Stenosis

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...

Survival by stroke volume index in patients with low-gradient normal EF severe aortic stenosis.

OBJECTIVE Low-gradient (LG) severe aortic stenosis (AS) and preserved EF with reduced stroke volume are associated with an adverse prognosis, but the relationship of stroke volume index (SVI) with mortality among a range of values is unknown. We investigated the prognostic impact of SVI in this population. METHODS We examined 405 consecutive patients with preserved EF (≥50%) and severe AS (va...

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...