Abstract

ERDOCIAIN PERALES, Mar; ZUAZOLA MARTINEZ, Pilar  and  CAY DIARTE, Eduardo. Low-flow, low-gradient severe aortic stenosis with preserved systolic function, a diagnostic and therapeutic goal: What do we know today?. Rev. Colomb. Cardiol. [online]. 2017, vol.24, n.1, pp.48-55. ISSN 0120-5633.  https://doi.org/10.1016/j.rccar.2016.05.009.

Low-flow, low-gradient severe aortic stenosis with preserved ejection fraction of the left ventricle is a frequent entity of clinical practice. It can probably represent a more advance phase of the illness with a heavier load or time frame and a restrictive pathophysiology. There are typical clinical, hemodynamic and echocardiographic characteristics. It is an underdiagnosed condition, and as such it is undertreated, with a clearly worse prognosis with conservative treatment. In many cases, the help of «multiimaging» is required for an appropriate diagnosis and choosing the therapeutic moment. Valve replacement in patients with paradoxical low-flow, low-gradient severe aortic stenosis seem to show higher mortality in the short and long term when compared to patients with normal flow, and similar mortality if compared to low-flow aortic stenosis with depressed ejection fraction of the left ventricle. There is a lower mortality with the transcatheter aortic valve implantation in comparison with treatment of patients with symptomatic low-flow severe aortic stenosis, both for a low ejection fraction and for the paradoxical low flow, considered inoperable. No current evidence seems to exist to recommend percutaneous approach versus aortic valve replacement in high surgical risk patients with aortic stenosis with paradoxical low flow severe aortic stenosis.

Keywords : Severe aortic stenosis; Paradoxical low flow; Preserved ejection fraction.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )