An 82-year-old male was hospitalized complaining of dyspnea for 1 year and aggravating for 2 weeks. He had been treated in other hospitals for several times due to such situation and his symptom could be relieved by diuretics. After admission, he was diagnosed as severe aortic stenosis with extremely low left ventricular contractile function; transthoracic echocardiography showed a left ventricular ejection fraction of only 16.1%. He was classified as a typical case of severe aortic stenosis with “low transaortic velocity and low transaortic gradient” since the transaortic velocity being 2.36 m/s and transaortic gradient being 22/14 mm Hg (1 mm Hg=0.133 kPa). Dobutamine-stress echocardiography suggested that the patient’s left ventricular reserve function was extremely poor and the potential benefits of valvular surgery were finite as the former data being 2.59 m/s and 27/16 mm Hg respectively. In consideration of progressive exacerbation of the patient’s symptoms, we eventually conducted transcatheter aortic valve replacement surgery with the support of extracorporeal membrane oxygenation. His symptoms such as dyspnea disappeared after the surgery and clinical parameters had also got a significant improvement.
Citation： WANG Yan, WANG Bin, SUN Guangfeng. A case of transcatheter aortic valve replacement of severe aortic stenosis with extremely low left ventricular ejection fraction. West China Medical Journal, 2020, 35(4): 406-411. doi: 10.7507/1002-0179.202002376 Copy