Paradoxical low-flow, low-gradient severe aortic stenosis with only mild aortic valve calcification

DOI: 10.4244/EIJ-D-19-00778

Xi Li1, ; Xin Wei2, ; Hong Tang3, ; Mao Chen4, ;

1. Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China, China
2. Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
3. Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
4. Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China

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A 71-year-old male was admitted to our hospital for chest distress and dyspnea. Transthoracic echocardiography (TTE) revealed concomitant aortic and mitral stenosis with significant thickening of both valves, suggesting rheumatic heart disease. The left ventricle was small and severely hypertrophied (Panel 1A). Hemodynamic measurements (ejection fraction [EF] 69%, stroke volume index 24.17 ml/m², mean pressure gradient 26 mmHg, peak jet velocity 3.2 m/s, effective valve orifice area 0.7cm²) (Panel 1B) suggested low-flow, low-gradient aortic stenosis (LFLG-AS) with preserved EF.

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aortic stenosistavitransthoracic echocardiogram

Interventions for valvular diseaseTAVI

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