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Brain & Heart TAVR in low gradient aortic stenosis

Table 2. Key studies on low-flow low-gradient aortic stenosis and their outcomes
First author, Year Study design Objective Number of patients/studies Outcome
included
Ribeiro et al., 2018 71 A prospective To evaluate the clinical outcomes and 287 patients TAVR was superior to
multicenter registry changes in LVEF following TAVR in SAVR with better peri-
study patients with classical LFLGAS. procedural outcomes and
overall improvement in LVEF
irrespective of the presence or
absence of contractile reserve at
the 1-year follow-up in patients
with LFLGAS.
Maes et al., 2019 72 A prospective To evaluate the clinical outcomes and 293 patients, including 128 Patients with LFLGAS
multicenter registry alterations in LVEF following TAVR in with very low LVEF (<30%) and severe left ventricular
study patients with LFLGAS and severe left and 165 with low LVEF dysfunction showed
ventricular dysfunction. (30% – 40%) comparable clinical outcomes
of TAVR to those in patients
with only mildly reduced
LVEF function and exhibited
a significant improvement in
LVEF over time, irrespective
of the degree of baseline left
ventricular dysfunction.
Ueyama et al., Meta-analysis To evaluate the impact of AVR in 6515 patients from 32 studies AVR was associated with a
2021 10 patients with each subclass of LGAS, substantial decrease in all-cause
including LFLG, paradoxical LFLG, mortality in all subclasses
and NFLGAS, and compare the clinical of LGAS, with no observed
outcomes following SAVR and TAVR. difference between SAVR and
TAVR.
Chiang et al., 2024 74 Retrospective single- • To estimate and assess the alterations 170 patients • Significant improvement
center study in functional status based on the in NYHA class and KCCQ
NYHA score and quality of life metrics scores were observed at 30
using the KCCQ in patients with three days and 1 year in all three
variants of severe, low-gradient AS at subclasses of LGAS following
30 days and 1 year following TAVR. TAVR, but no significant
• To evaluate secondary outcomes difference was noted between
such as all-cause mortality and major the subclasses.
adverse cardiovascular events. • No significant difference
was noted in the secondary
outcomes.
Freitas-Ferraz A prospective To estimate the incidence, clinical 308 patients Patients with TAVR developed
et al., 2020 75 multicenter study outcomes, and changes in the severity of functional MR, which resolved
MR over time in patients with LFLGAS significantly over time. The lack
undergoing TAVR. of improvement at 1 year was
correlated with poor clinical
outcomes.
Dayan et al., 2015 73 Meta-analysis To analyze the impact of AVR on 18 studies Patients with paradoxical
mortality and survival in patients with LFLGAS and NFLGAS
LGAS and preserved LVEF and those exhibited an increased risk of
with high-gradient AS or moderate AS. mortality compared with those
with other subtypes of AS and
showed improved outcomes
with AVR.
Lauten et al., 2014 76 A prospective To analyze the outcome of patients 3908 patients The in-hospital and 1-year
multicenter registry undergoing TAVI for various subtypes of mortality and complication
study severe AS. rates after TAVI among patients
with PLFLGAS were low and
comparable to those for high-
gradient AS. Patients with low
(Cont’d...)

Volume 3 Issue 1 (2025) 11 doi: 10.36922/bh.4017