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Abstract Summary New advances in cardiac surgery including myocardial protection techniques and perioperative monitoring and care protocols mandates reevaluation of previously determined risk groups and risk factors in light of these advances. Aortic stenosis is becoming common entity; we face nowadays, for more oriented and physically active patients seeking for medical service to provide treatment with safe st procedure and best long - term outc ome. Surgical aortic valve replacement provides proved long - term outcome for aortic stenosis relieve; but it is still has morbidities and mortalities especially in subgroup of patients with left ventricular dysfunction that make physicians and patients too k time to revise decision making in best option for that patients to relieve their left ventricular outflow obstruction. Low transvalvular gradient was thought to increase risk of procedure and alarming less favorable surgical outcome, sending more patient s away from surgery to less profitable treatments as medical treatments with statins and angiotensin converting enzyme inhibitors and in recent years to more profitable appealing option of transcatheter aortic valve replacement. We designed our study to ev aluate the effect of mean transvalvular gradient on outcome of surgical aortic valve replacement for those patients with severe aortic stenosis and low left ventricular ejection fraction. This study included forty patients presented with severe aortic ste nosis and low ejection fraction. They were subdivided into two groups according to mean transvalvular gradient as Group A (High pressure) with mean pressures more than 40 mmHg and Group B (Low pressure) with mean pressures less than 40 mmHg. |