The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Editorial

Low-flow, low-gradient aortic stenosis: should TAVI be the default therapeutic option?

EuroIntervention 2014;10:775-777. DOI: 10.4244/EIJV10I7A134

1. Department of Cardiology, Bern University Hospital, Bern, Switzerland; 2. Department of Cardiology, Stadtspital Triemli, Zürich, Switzerland
Aortic stenosis (AS) haemodynamic severity is typically quantified using aortic valve area (AVA) and the transvalvular mean gradient (MG)1. The 2012 European Society of Cardiology/European Association of Cardiothoracic Surgery guideline consensus document defines severe AS as an MG >40 mmHg and an AVA <1.0 cm2 in the presence of a normal cardiac output1. However, because MG is directly proportional to the square of transvalvular flow, even small reductions in stroke volume can result in significant reductions in the pressure gradient (Figure 1). Furthermore, stroke volume reductions can occur even in the presence of apparently normal left ventricular ejection fraction (LVEF)2. Consequently, ...

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