Hemodynamic Assessment of Patients With Low-Flow, Low-Gradient Valvular Aortic Stenosis
Why the study?
Which index of stenosis severity is most flow-independent during dobutamine challenge in patients with low-flow, low-gradient critical aortic stenosis?
Population
8 patients with low-flow, low-gradient critical aortic stenosis
Comparison
Hemodynamic assessment after transvalvular flow… vs Baseline hemodynamic assessment
Design
Case_series
Authors
Discussion
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Implication
Valve resistance may be most flow-independent in low-flow low-gradient AS; hypothesis-generating and should not yet change practice.
Structured PICO
Which index of stenosis severity is most flow-independent during dobutamine challenge in patients with low-flow, low-gradient critical aortic stenosis?
P
Population
8 patients with low-flow, low-gradient critical aortic stenosis (valve area ≤ 0.7 cm2, cardiac output < 4.0 L/min, and mean transvalvular gradient ≤ 40 mm Hg)
I
Intervention
Hemodynamic assessment after transvalvular flow augmentation with dobutamine infusion, followed by percutaneous balloon aortic valvuloplasty
C
Comparator
Baseline hemodynamic assessment (within-patient comparison)
O
Outcome
Changes in 3 indexes of stenosis severity: Gorlin formula calculated valve area, valvular resistance, and percentage left ventricular stroke work losssurrogate
In patients with low-flow, low-gradient critical aortic stenosis, valve resistance is the most flow-independent measure of stenosis severity during dobutamine challenge.
Cite This Study
Blitz et al. (1996) studied this question.