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Flow is physiology. Sub physiological valve destruction very much possible without affecting gradient. As a cardiologist, very soon we will be allowed legally to choose TAVI even in more younger , low risk cohort of Aortic stenosis without co-morbid conditions. It was not mandatory. Did TEE/CT follow up imaging done ?
A transthoracic echocardiogram showed an LV EF of less than 15%, critically severe aortic stenosis , severe LVH , and a small LV cavity. The aortic valve in this example also had critical stenosis by Doppler The patient continued to be hemodynamically unstable with poor cardiac output and very high LV filling pressures.
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