Reasons for Not Performing Low-Dose Dobutamine Stress Echocardiography in Patients with Classical Low-Flow, Low-Gradient Severe Aortic Stenosis Before Transcatheter Aortic Valve Replacement: The Optimized Transcatheter Valvular Intervention–Transcatheter Aortic Valve Implantation Registry

2018 ◽  
Vol 31 (12) ◽  
pp. 1366-1368 ◽  
Author(s):  
Akihisa Kataoka ◽  
Yusuke Watanabe ◽  
Kentaro Shibayama ◽  
Kazuki Mizutani ◽  
Toru Naganura ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Stress Echocardiography ◽  
Low Dose ◽  
Dobutamine Stress Echocardiography ◽  
Severe Aortic Stenosis ◽  
Dobutamine Stress ◽  
Low Flow ◽  
Transcatheter Aortic Valve ◽  
Valve Implantation

scholarly journals The clinical significance of the incorporation of tissue Doppler imaging into low-dose Dobutamine stress echocardiography in patients with aortic stenosis prior to Transcatheter aortic valve implantation

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sahrai Saeed ◽  
Joerg Kellermair ◽  
Jon Herstad ◽  
Øyvind Bleie
Keyword(s):  
Aortic Valve ◽  
Low Dose ◽  
Contractile Function ◽  
Tissue Doppler ◽  
Dobutamine Stress ◽  
Doppler Imaging ◽  
Low Flow ◽  
Transcatheter Aortic Valve ◽  
Mean Pressure ◽  
Valve Implantation

Abstract Background Low-dose dobutamine stress echocardiography (DSE) is indicated in patients with low flow (stroke volume index [SVi] < 35 ml/m2) low gradient (mean pressure gradient < 40 mmHg) and left ventricular ejection fraction (LVEF) < 50% aortic stenosis (AS) to assess LV contractile reserve (> 20% increase in SVi) and severity grade of AS. Severe AS is defined by a mean pressure gradient of 40 mmHg occurring at any time during the test when aortic valve area remains < 1.0 cm2. Case presentation This case report highlights the utility of mitral annular systolic velocity (S′) by tissue Doppler imaging and peak LV outflow tract (LVOT) velocity as markers of LV intrinsic contractile function during DSE in a patient with low flow low gradient AS and reduced EF prior to transcatheter aortic valve implantation (TAVI). Conclusions Mitral annular S′ and peak LVOT velocities are reliable markers of LV intrinsic contractile function and should be incorporated into routine low-dose DSE.

scholarly journals Calcification Characteristics of Low-Flow Low-Gradient Severe Aortic Stenosis in Patients Undergoing Transcatheter Aortic Valve Replacement

2015 ◽  
Vol 2015 ◽  
pp. 1-8
Author(s):  
Barbara E. Stähli ◽  
Thi Dan Linh Nguyen-Kim ◽  
Cathérine Gebhard ◽  
Thomas Frauenfelder ◽  
Felix C. Tanner ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Low Flow ◽  
Aortic Valve Calcification ◽  
Valve Calcification ◽  
Transcatheter Aortic Valve

Low-flow low-gradient severe aortic stenosis (LFLGAS) is associated with worse outcomes. Aortic valve calcification patterns of LFLGAS as compared to non-LFLGAS have not yet been thoroughly assessed. 137 patients undergoing transcatheter aortic valve replacement (TAVR) with preprocedural multidetector computed tomography (MDCT) and postprocedural transthoracic echocardiography were enrolled. Calcification characteristics were assessed by MDCT both for the total aortic valve and separately for each leaflet. 34 patients had LFLGAS and 103 non-LFLGAS. Total aortic valve calcification volume (p<0.001), mass (p<0.001), and density (p=0.004) were lower in LFLGAS as compared to non-LFLGAS patients. At 30-day follow-up, mean transaortic pressure gradients and more than mild paravalvular regurgitation did not differ between groups. In conclusion, LFLGAS and non-LFLGAS express different calcification patterns which, however, did not impact on device success after TAVR.

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