Percutaneous Balloon Aortic Valvuloplasty for Severe Aortic Stenosis: Haemodynamic Evaluation by Echocardiography

Abstract

the continuity equation usingVTImeasurements. Dimensionless index (DI) was defined by LVOTVTI/AVVTI. Mean LVOT flow rate was determined by stroke volume divided by systolic ejection time. Results: A 109 patients (43% f) had LGAS (MG 31± 7mmHg) and 142 (57%) had HGAS (MG 55± 13mmHg, p< 0.001). Age, height and body weight were similar in the two groups. There were no differences in heart rate or systolic or diastolic blood pressure taken at the time of echocardiography. In comparison with HGAS, patients with LGAS had larger AVA (0.797± 0.114 vs 0.713± 0.148 cm2, p< 0.001) and higherDI (0.25± 0.06 vs 0.20± 0.04, p< 0.001), but lower LV stroke volume (71± 14 vs 85± 20ml, p< 0.001) and lower LVOT flow rate (220± 36 vs 255± 58ml/s, p< 0.001). Conclusions: In this consecutive series of patients with severe AS and preserved LVEF, LGAS was highly prevalent. Whilst LGAS patients have slightly larger AVA in comparison with HGAS, they also have smaller LV stroke volumes and lower transvalvular flow rates. This suggests that LGAS is a real phenomenonwith thepathophysiology partly explained by “less brisk” LV systolic function. doi:10.1016/j.hlc.2011.05.459