Patients With Severe AS, Low SVi, Low TFR Have Worse Survival After TAVR

Background: Stroke volume index (SVi) is a volume-based measurement and an important measure in the evaluation of aortic stenosis (AS). However, SVi differs from actual flow, which is measured as transaortic flow rate (TFR) and quantified in mL/s. Discordance between SVi and flow may occur and has clinical implications. Objective: To determine whether volume–flow (V–Q) discordance is associated with survival outcomes in patients with severe AS undergoing transcatheter aortic valve replacement (TAVR). Design: Retrospective registry analysis. Participants: Patients aged ≥65 years who underwent TAVR for severe trileaflet AS (aortic valve area, ≤1.0 cm 2 ) and had both SVi and TFR measured before TAVR, with 3-year follow-up. The patients underwent transthoracic echocardiography and measurements, including BP, SVi, and TFR, before TAVR. Classical severe AS was present in 40%; discordant severe AS in 32%; severe low-flow, low-gradient AS in 23%; and paradoxical low-flow, more...