Risk stratification in asymptomatic moderate to severe aortic stenosis: the importance of the valvular, arterial and ventricular interplay. Heart. 2010;96:1364 71. 16. Kang D-H, Park S-J, Rim JH, et al. Early surgery versus conventional treatment in asymptomatic very severe aortic stenosis. Circulation. 2010;121:1502 9. 17. Tribouilloy C, L vy F, Rusinaru D, et al. Outcome after aortic valve re- placement for low-flow/low-gradient aortic stenosis without contrac- tile reserve on dobutamine stress echocardiography. J Am Coll Cardiol. 2009;53:1865 73. 18. Herrmann HC, Pibarot P, Hueter I, et al. Predictors of mortality and outcomes of therapy in low-flow severe aortic stenosis: a Placement of Aortic Transcatheter Valves (PARTNER) trial analysis. Circulation. 2013;127:2316 26. 19. Anjan VY, Herrmann HC, Pibarot P, et al. Evaluation of flow after trans- catheter aortic valve replacement in patients with low-flow aortic stenosis: a secondary analysis of the PARTNER randomized clinical trial. JAMA Car- diol. 2016;1:584 92. 20. Lopez-Marco A, Miller H, Youhana A, et al. Low-flow low-gradient aortic stenosis: surgical outcomes and mid-term results after isolated aortic valve replacement. Eur J Cardiothorac Surg. 2016;49:1685 90. 21. O Sullivan CJ, Englberger L, Hosek N, et al. Clinical outcomes and revascu- larization strategies in patients with low-flow, low-gradient severe aortic valve stenosis according to the assigned treatment modality. JACC Cardio- vasc Interv. 2015;8:704 17. 22. Nishimura RA, Grantham JA, Connolly HM, et al. Low-output, low-gradi- ent aortic stenosis in patients with depressed left ventricular systolic func- tion: the clinical utility of the dobutamine challenge in the catheterization laboratory. Circulation. 2002;106:809 13. 23. Monin J-L, Qu r J-P, Monchi M, et al. Low-gradient aortic stenosis: op- erative risk stratification and predictors for long-term outcome: a mul- ticenter study using dobutamine stress hemodynamics. Circulation. 2003;108:319 24. 24. Foug res E, Tribouilloy C, Monchi M, et al. 