Low gradient aortic stenosis

Current Treatment Options in Cardiovascular Medicine
Katie M Doucet, Ian G Burwash

Abstract

Severe low-gradient (LG) aortic stenosis (AS) [aortic valve area (AVA) ≤ 1.0 cm(2), mean pressure gradient (MG) < 40 mmHg] represents a frequently encountered and challenging clinical dilemma. A systematic approach, which often requires several imaging modalities, should be undertaken to confirm the hemodynamic findings and rule out measurement error. Low-flow conditions often account for the discrepancy and can be present whether the left ventricular ejection fraction (LVEF) is depressed or normal. In patients with classical low-flow (LF), LG AS in which LVEF is reduced (<40-50 %), dobutamine stress echocardiography (DSE) should be used to distinguish patients with true severe AS and pseudo-severe AS, as well as to evaluate for the presence of left ventricular contractile or flow reserve. Surgical or transcatheter aortic valve replacement (AVR) should likely be reserved for those patients with true severe AS. Patient outcome with medical or surgical management generally relates to patient functional capacity, stenosis severity, and left ventricular functional reserve. Patients with severe LG AS with preserved LVEF can have a stroke volume that is either normal (>35 mL/m(2)) or low (<35 mL/m(2)). New data suggest that DSE can i...Continue Reading

References

Mar 1, 2002·The New England Journal of Medicine·Blase A Carabello
Aug 14, 2002·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Ian G BurwashKwan L Chan
Feb 8, 2007·Current Opinion in Cardiology·Ian G Burwash
Dec 25, 2007·European Heart Journal·Jan MinnersNikolaus Jander
Mar 11, 2008·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Tomas G NeilanArthur E Weyman
Jan 10, 2009·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Helmut BaumgartnerUNKNOWN European Association of Echocardiography
Jun 24, 2009·Circulation·Jean-Luc MoninPascal Guéret
Sep 5, 2009·Journal of the American College of Cardiology·Zeineb HachichaPhilippe Pibarot
Dec 22, 2009·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Hiromi NakaiYutaka Otsuji
Aug 1, 2008·Circulation. Cardiovascular Interventions·Nicoló PiazzaRobert H Anderson
Apr 7, 2010·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Marie-Annick ClavelPhilippe Pibarot
Jun 2, 2010·European Heart Journal·Ralph A H StewartUNKNOWN New Zealand Heart Valve Study Investigators
Feb 16, 2011·Circulation·Nikolaus JanderChrista Gohlke-Bärwolf
Jul 16, 2011·Journal of the American College of Cardiology·Sebastian HerrmannFrank Weidemann
Aug 2, 2011·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Michael GotzmannAndreas Mügge
Jan 14, 2012·Journal of the American College of Cardiology·Patrizio LancellottiLuc A Piérard
Feb 18, 2012·The Journal of Thoracic and Cardiovascular Surgery·Joseph MaloufMaurice Enriquez-Sarano
Apr 14, 2012·The American Journal of Cardiology·Toshio SaitoMinoru Yoshiyama
May 26, 2012·JACC. Cardiovascular Interventions·Alexander LautenUNKNOWN German Transcatheter Aortic Valve Interventions Registry Investigators
Jun 5, 2012·Journal of the American College of Cardiology·Marie-Annick ClavelPhilippe Pibarot
Jun 27, 2012·European Heart Journal·Emilie FougèresJean-Luc Monin
Aug 28, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Alec VahanianUNKNOWN European Association for Cardio-Thoracic Surgery (EACTS)
Oct 16, 2012·Journal of the American College of Cardiology·Philippe Pibarot, Jean G Dumesnil

❮ Previous
Next ❯

Citations

Oct 14, 2018·Clinical Cardiology·Constantina AggeliDimitrios Tousoulis

❮ Previous
Next ❯

Related Concepts

Related Feeds

Angelman Syndrome

Angelman syndrome is a neurogenetic imprinting disorder caused by loss of the maternally inherited UBE3A gene and is characterized by generalized epilepsy, limited expressive speech, sleep dysfunction, and movement disorders. Here is the latest research.

Related Papers

EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Marie-Annick Clavel, Philippe Pibarot
Italian Heart Journal : Official Journal of the Italian Federation of Cardiology
Alfredo ZuppiroliAlberto Dolara
Journal of the American College of Cardiology
Philippe Pibarot, Jean G Dumesnil
© 2021 Meta ULC. All rights reserved