Clinical Outcome of Patients with Low-Flow Low-Gradient Severe Aortic Stenosis According to Assigned Treatment Modality

Adi Butnaru Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Shalom Silberman Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel David Rosenmann Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Rivka Farkash Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Marc Klutstein Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Yaron Almagor Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Rafael Wolff Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Jonathan Balkin Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Rami Jubeh Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Mady Moriel Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Tal Hasin Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Michael Glikson Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Shmuel Gottlieb Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel

Background: The optimal treatment modality for patients with low flow low gradient (LFLG) severe aortic stenosis (AS) is unknown.

Objedtives: To compare clinical outcome of patients with LFLG severe AS following surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR).

Methods: 276 patients with LFLG severe as underwent SAVR or TAVR between 2006 -2017 at our center. Two groups were identified: true LFLG AS (n= 62, 23%) and paradoxical LFLG-AS (n = 214, 77%). The median follow up was 475(129-1211) days.

Conclusions: In patients with LFLG-AS, a better hemodynamic profile was noted with TAVR compared with SAVR, both in true and paradoxical LFLG AS patients. In the entire cohort, survival was comparable for SAVR and TAVR, but better for patients aged ≥ 75 yrs. Our data suggest that TAVR should be the preferred treatment modality.

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Presentation

Adi Butnaru