Low flow low gradient aortic stenosis: clinical pathways

Low flow low gradient aortic stenosis: clinical pathways

Blog Article

Aortic stenosis patients with severe LV dysfunction and low cardiac output present with relatively low transvalvular gradients.It is F-Connector difficult to distinguish them from aortic sclerosis and LV dysfunction with low cardiac output.The former condition is severe AS with LV dysfunction and latter is primarily a contractile dysfunction.

Dobutamine stress echocardiogram is key to diagnosis.AS with LV dysfunction associated with preserved contractile reserve benefit from valve replacement and those without contractile reserve needs critical evaluation on a case to case basis.Patients of AS with LV dysfunction with associated coronary artery disease need coronary angiograms to decide regarding need for valve replacement with bypass surgery.

A subset of AS patients have low flow, low mean gradients with preserved ejection Shirts fraction in whom one must evaluate global hemodynamic load to assess ventriculo-arterial impedence.In this review an approach to the clinical pathways for assessment of low flow, low gradient aortic stenosis has been discussed.