O'Sullivan, Crochan John; Praz, Fabien; Stortecky, Stefan; Windecker, Stephan; Wenaweser, Peter Martin (2014). Assessment of low-flow, low-gradient, severe aortic stenosis: an invasive evaluation is required for decision making. EuroIntervention, 10 Suppl U, U61-U68. Europa Digital & Publishing 10.4244/EIJV10SUA9
Full text not available from this repository.Low-flow, low-gradient severe aortic stenosis (AS) is characterised by a small aortic valve area (AVA) and low mean gradient (MG) secondary to a low cardiac output and may occur in patients with either a preserved or reduced left ventricular ejection fraction (LVEF). Symptomatic patients presenting with low-flow, low-gradient severe AS have a dismal prognosis independent of baseline LVEF if managed conservatively and should therefore undergo aortic valve replacement if feasible. Transthoracic echocardiography (TTE) is the first-line investigation for the assessment of AS haemodynamic severity. However, when confronted with guideline-discordant AVA (small) and MG (low) values, there are several reasons other than severe AS combined with a low cardiac output which may lead to such a situation, including erroneous measurements, small body size, inherent inconsistencies in the guidelines' criteria, prolonged ejection time and aortic pseudostenosis. The distinction between these various entities poses a diagnostic challenge. However, it is important to make a distinction because each has very different implications in terms of risk stratification and therapeutic management. In such instances, cardiac catheterisation forms an integral part of the work-up of these patients in order to confirm or refute the echocardiographic findings to guide management decisions appropriately.
Item Type: |
Journal Article (Further Contribution) |
---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
O'Sullivan, Crochan John, Praz, Fabien Daniel, Stortecky, Stefan, Windecker, Stephan, Wenaweser, Peter Martin |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1774-024X |
Publisher: |
Europa Digital & Publishing |
Language: |
English |
Submitter: |
Judith Liniger |
Date Deposited: |
06 May 2015 09:00 |
Last Modified: |
02 Mar 2023 23:25 |
Publisher DOI: |
10.4244/EIJV10SUA9 |
PubMed ID: |
25256333 |
URI: |
https://boris.unibe.ch/id/eprint/61983 |