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La estenosis aórtica muy grave se ha definido de maneras distintas según los autores y las propias guías de práctica clínica. Para Kang et al 19, una estenosis aórtica es muy grave cuando el área valvular es < 0,75 cm 2, acompañada de una velocidad transvalvular aórtica máxima > 4,5 m/s o un gradiente medio > 50 mmHg.
Supplemental calcium with or without vitamin D is associated with lower survival and greater aortic valve replacement in elderly patients with mild to moderate aortic stenosis. How might this impact on clinical practice?
17 de dic. de 2020 · Stage D1 reflects patients with high-gradient symptomatic AS (V max ≥4.0 m/s, mean gradient ≥40 mm Hg, aortic valve area [AVA] ≤1.0 cm 2 ); Stage D2 reflects low-flow, low-gradient severe AS with reduced LVEF (AVA ≤1.0 cm 2, V max <4.0 m/s or mean gradient <40 mm Hg, LVEF <50%); and Stage D3 reflects low-flow, low-gradient severe AS with normal ...
8 de dic. de 2015 · A low flow state may occur with reduced left ventricular ejection fraction (LVEF) (i.e. Classical Low Flow) or with preserved LVEF (i.e. Paradoxical Low Flow) and it is often associated with a low transvalvular gradient given that the gradient is highly flow-dependent 1, 2. In both types of low-flow, low-gradient (LF-LG), classical ...
D3: Symptomatic severe low-gradient AS with normal LVEF (>50%) or paradoxical low-flow severe AS. D1, D2, and D3 may show: − Severe leaflet calcification/fibrosis with reduced leaflet motion. D1: Vmax ≥4 m/s or mean ∆P ≥40 mmHg, AVA typically ≤1 cm2 (or AVAi 0.6 cm2/m2) but may be larger with mixed. AS/AR.
15 de abr. de 2015 · The ACC/AHA guidelines recommend aortic valve replacement (AVR) as a Class IIa (Level of Evidence: C) recommendation in D3 AS patients: "AVR is reasonable in symptomatic patients who have low-flow, low-gradient severe AS who are normotensive and have a LVEF ≥50% if clinical, hemodynamic, and anatomic data support valve obstruction ...
The 2014 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines (2) classified this “paradoxical” LF/LG entity as a D3 stage of aortic stenosis, which is defined as an aortic valve area (AVA) of <1.0 cm 2, an indexed AVA of <0.6 cm 2 /m 2, a mean gradient of <40 mm Hg, a LVEF of >50%, and a stroke volume index (SVi) of ...
