Symptomatic Low-Gradient Severe Aortic Stenosis With Preserved Left Ventricular Ejection Fraction

Symptomatic low-gradient severe aortic stenosis with preserved left ventricular ejection fraction: now less of a clinical conundrum.

Low-flow aortic stenosis and preserved left ventricular ejection fraction.

Valvular aortic stenosis (AS) is the most frequent valvular disease in developed countries. Treatment decisions in AS are mainly based upon the symptomatic status of the patient and the severity of AS. Doppler echocardiography represents the standard tool for detecting and assessing the severity of the disease. Under the same denomination of severe AS [aortic valve area (AVA) < 1 cm(2)], severa...

Impact of aortic valve replacement on outcome of symptomatic patients with severe aortic stenosis with low gradient and preserved left ventricular ejection fraction.

BACKGROUND The optimal management of low-gradient "severe" aortic stenosis (mean gradient <40 mm Hg, indexed aortic valve area ≤0.6 cm2/m2) with preserved left ventricular ejection fraction remains controversial because gradients may be similar after aortic valve replacement (AVR). We compared outcomes of low-gradient severe aortic stenosis with AVR or medical therapy. METHODS AND RESULTS Com...

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...

Exercise Echocardiography in Asymptomatic Patients with Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction

The management of asymptomatic patients with severe aortic stenosis (AS) remains controversial. Recent series reported that early aortic valve replacement might be associated with improved clinical outcomes. However, the risk-benefit ratio should be carefully evaluated and early surgery only be proposed to a subset of asymptomatic patients considered at higher risk. Exercise echocardiography ca...