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Figure 6 Example of decision making with moderate aortic stenosis (AS) and aortic regurgitation (AR). This 59-year-old man has a markedly calcified aortic valve, but aortic velocity is only 3.7 m/s, mean gradient 34 mm Hg, and valve area is 1.3 cm2. Moderate regurgitation also is present with a vena contract of 5 mm, and holodiastolic flow reversal in the descending aorta. However, significant left ventricular dilation and systolic dysfunction are present, so that aortic valve replacement is appropriate. EF = ejection fraction; ESD = end-systolic dimension.
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