Immediate improvement of left atrial appendage contractility after transcatheter aortic valve replacement in a patient with paradoxical low-flow low-gradient aortic stenosis and preserved left ventricular function

Paradoxical low-flow, low-gradient severe aortic stenosis with preserved left ventricular (LV) ejection fraction is a recently recognized entity characterized by impaired LV filling, altered myocardial function, and worse prognosis. We have shown, for the first time that transcatheter aortic valve replacement is associated with immediate improvement of left atrial mechanical function, as demonstrated by the disappearance of spontaneous echo contrast and increase in left atrial appendage contractility.