Dr. Catherine M. Otto
This Focus session started with a case presentation by Raphael Rosenhek on an elderly asymptomatic patient with very severe aortic stenosis (AS). A step-by-step approach to this clinical problem was summarized by Catherine Otto as follows:
Next, Nikolaus Jander presented a case of low-gradient AS with preserved LV ejection fraction in an asymptomatic patient, showing that this patient had only moderate AS and did well with watchful waiting over a long follow-up interval. In contrast, Patrizio Lancellotti presented a case of symptomatic low-gradient AS with preserved ejection fraction, showing that this patient did, in fact, have severe AS and benefited from transcatheter aortic valve replacement. The panel discussed approaches to diagnosis of severe AS in patient with low-output AS emphasizing the importance of clinical symptoms, the need to evaluate other potential causes of symptoms (such as coronary or pulmonary disease) and the role of imaging and stress testing in this challenging clinical situation.
Severe aortic stenosis: which patient? Which valve?
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