Z va score in Aortic stenosis : No more a theoretical concept

It was the final case on weekend Echocardiogram review day, I asked my fellow for a brief summary of the patient. A 3 minute conversation“Yes, sir, he is a 62-year-old male retired govt officer. He has a severely stenosed aortic valve, with a peak gradient of 90 mmHg and a mean gradient that comes to almost 50 mmHg. LV  EF is 58%, GLS is 18, LVH is obvious. LA is not dilated (Didn’t measure volume though), but DT is short. Valve orifice is hovering around 1cm, mild calcium noted in LCC  I am not sure whether it’s bi or tricuspid still. The annulus is 22mm. The mitral valve is perfect, no calcium spill over to the mitral curtain and the rest of the annulus”.“That is ok, what for he has come”?“A GP from Tambaram has referred him after he detected a murmur over the chest”. “Oh Ok. What are his symptoms”?“He is denying any symptoms”.  “Are you sure? did you ask him specifically about it during exertion”? “Yes, he says he can climb 3 flights of stairs. (In fact, he was sort of amused when I told him to be frank in his expression, and   he has a potentially serious obstruction in the main valve that connects his heart and body.” “I agree, but his reaction was not so inappropriate I thought, after all, he didn’t feel any symptoms right”.“So what shall we do for him?  TAVR? SAVR? Leave him alone?  Shall we put him on the treadmill? to document symptoms? Is...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: aortic stenosis Aortic valve replacement asymptomatic severe aortic stenosis tavr vs savr for aortic stenosis zva score in aortic stenosis Source Type: blogs