Updates to a Modern Dilemma: a Practical Approach to the Workup and Management of Low-Gradient Severe Aortic Stenosis Using Transvalvular Flow Rate

To provide a new and practical approach for clinicians assessing and managing patients with low-gradient severe aortic stenosis (AS) using recent data highlighting the importance of transvalvular flow rate in AS assessment. Recent data have highlighted the unifying underpinning of low-gradient severe AS to be low transvalvular flow rate, and shown the impact that flow rate has on diagnostic and prognostic utility in AS. Additional developments in echocardiographic measurement technique and non-echocardiographic modalities have also been made which can help tackle this clinical conundrum. Low-gradient severe AS is a challenging condition to diagnose and manage. Here we provide a new approach using transvalvular flow rate, with a practical clinically oriented guide, and a summary of recent evidence.