Low-Flow, Low-Gradient AS Conclusion Builder

Low-Flow, Low-Gradient AS Conclusion Builder

Core Echo Inputs

AVA (cm²) Indexed AVA (cm²/m²) Vmax (m/s) Mean gradient (mmHg) Dimensionless Index (LVOT/AV VTI or Vpeak)

LV & Flow

LVEF (%) Stroke Volume Index (mL/m²) Body Surface Area (m²)

Confirmatory Testing

Sex for CT AU threshold — Female (true severe ≥ 1200 AU) Male (true severe ≥ 2000 AU) CT Aortic Valve Calcium (Agatston units)

DSE (for reduced EF)

DSE performed DSE shows AVA ≤ 1.0 cm² with rise in gradient (true severe) DSE shows AVA increases > 1.0 cm² (pseudo-severe)

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Conclusion text

Tips: LF-LG pattern requires AVA ≤ 1.0 cm² (or indexed ≤ 0.6), mean gradient < 40 mmHg, Vmax < 4.0 m/s, and SVI < 35 mL/m². Classical = LVEF < 50%; paradoxical = LVEF ≥ 50%. True severe confirmed by DSE (classical) or CT calcium (paradoxical).