Immediate Improvement of Left Atrial Appendage Contractility after Transcatheter Aortic Valve Replacement in a Patient with Paradoxical Low-Flow Low-Gradient Aortic Stenosis and Preserved Left Ventricular Function

Abstract

Paradoxical low-fl ow, low-gradient severe aortic stenosis with preserved left ventricular (LV) ejection fraction is a recently recognized entity characterized by impaired LV fi lling, altered myocardial function, and worse prognosis. We have shown, for the fi rst time that transcatheter aortic valve replacement is associated with immediate improvement of left atrial mechanical function, as demonstrated by the disappearance of spontaneous echo contrast and increase in left atrial appendage contractility. Key words: Left atrial function, paradoxical low-fl ow, low-gradient severe aortic stenosis, transcatheter aortic valve replacement