Why the study?
Does the absence of preoperative left ventricular contractile reserve predict the absence of postoperative LVEF recovery in patients with low-gradient aortic stenosis undergoing AVR?
Does the absence of preoperative left ventricular contractile reserve predict the absence of postoperative LVEF recovery in patients with low-gradient aortic stenosis undergoing AVR?
Surgery (AVR) should not be contraindicated solely based on the absence of contractile reserve in low-gradient AS, as LVEF recovery is still possible.
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Absence of contractile reserve should not alone contraindicate AVR; leaves open optimal use of DSH for risk stratification in low-gradient AS.
LVEF increases in the majority of patients with low-gradient AS who survive after AVR. Although the absence of contractile reserve on DSH is related to high operative mortality, it does not predict the absence of LVEF recovery in patients surviving to AVR. These data further support the concept that surgery should not be contraindicated on the basis of absence of contractile reserve alone.
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Quéré et al. (2006) studied this question.
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