![]() ![]() Published on behalf of the European Society of Cardiology. The indications of the guidelines recommend surgical or percutaneous treatment, depending on the risk and comorbidities of the individual patient, both for patients with classic low-flow low-gradient AS and for those with paradoxical low-flow low-gradient AS.Īortic valve replacement Calcium score Low-flow low-gradient Severe aortic stenosis TAVI. ![]() Conversely, normal-flow low-gradient AS is associated with a better prognosis. Classical low-flow low-gradient AS has the worst prognosis, followed by paradoxical low-flow low-gradient AS (preserved LVEF). The prognostic impact of low-gradient AS is heterogeneous. The diagnostic tools needed to discriminate the different low-gradient AS phenotypes include colour-Doppler echocardiography, dobutamine stress echocardiography, computed tomography scan for the definition of the calcium score, and recently magnetic resonance imaging. This condition is called 'low-gradient AS' and includes very heterogeneous clinical entities, with different pathophysiological mechanisms. ![]() AVA ≤1 cm 2 (indicating severe AS) and a moderate gradient: >20 and <40 mmHg (typical of moderate stenosis). However, up to 40% of patients have a discrepancy between gradient and AVA, i.e. Aortic stenosis (AS) is defined as severe in the presence of: mean gradient ≥40 mmHg, peak aortic velocity ≥4 m/s, and aortic valve area (AVA) ≤1 cm 2 (or an indexed AVA ≤0.6 cm 2/m 2). ![]()
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