AS - PISA

ECHONOMY
Tools for Echocardiographic Calculations
Muhamed Saric, MD, PhD
New York University

Low-gradient AS

Purpose

Low-dose dobutamine infusion (usually around 5-10 ug/kg/min) is used to distinguish true AS from pseudo AS in patients with low LVEF and a low mean aortic gradient (<30 mm Hg) in whom the aortic valve area (AVA) calculates to <1.0 cm² at rest.

Decision Diagram

Alternative Decision Diagram

Reference

ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. J Am Coll Cardiol 2006 48(3):e1-148.

Grayburn, PA. Assessment of low-gradient aortic stenosis with dobutamine. Circulation 2006;113;604-606.