Management of Paradoxical Low-Flow, Low-Gradient 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...

Paradoxical Low - Flow , Low - Gradient Aortic Stenosis : New

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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...

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 (...

Paradoxical low-flow, low-gradient aortic stenosis: new evidence, more questions.