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Figure 4: ACC/AHA vs. ESC/EACTS algorithm for the diagnosis and management of low-flow low-gradient AS. *Integrated approach: further confirmation of severe AS is through CT-AV calcium scoring and calculation of the ratio of the outflow tract to aortic velocity.[18] Considering typical symptoms, LV hypertrophy or reduced LV longitudinal function additionally aid in defining severity.[19] ACC: American College of Cardiology, AHA: American Heart Association, AS: Aortic stenosis, AVA: Aortic valve area, AVR: Aortic valve replacement, CT-AVC: Computed tomography aortic valve calcium, EACTS: European Association of Cardiothoracic Society, ESC: European Society of Cardiology, LVEF: Left ventricular ejection fraction, MPG: Mean transortic pressure gradient, SV: Stroke volume, SVI: Stroke volume index

Figure 4: ACC/AHA vs. ESC/EACTS algorithm for the diagnosis and management of low-flow low-gradient AS. *Integrated approach: further confirmation of severe AS is through CT-AV calcium scoring and calculation of the ratio of the outflow tract to aortic velocity.<sup>[18]</sup> Considering typical symptoms, LV hypertrophy or reduced LV longitudinal function additionally aid in defining severity.<sup>[19]</sup> ACC: American College of Cardiology, AHA: American Heart Association, AS: Aortic stenosis, AVA: Aortic valve area, AVR: Aortic valve replacement, CT-AVC: Computed tomography aortic valve calcium, EACTS: European Association of Cardiothoracic Society, ESC: European Society of Cardiology, LVEF: Left ventricular ejection fraction, MPG: Mean transortic pressure gradient, SV: Stroke volume, SVI: Stroke volume index