ObjectivesTo investigate simple assess method of the degree of low transvalvular gradient aortic stenosis patients with impaired left ventricular function and to investigate aortic valve replacement indications, short and mid-term outcome of this kind of patients. MethodsWe retrospectively analyzed the clinical data of 21 low-gradient patients with impaired left ventricular function in our hospital from January 2011 through May 2014. There were 15 males and 6 females aged 41-66 (54.6± 10.7) years with mean aortic transvalvular gradient less than 40 mm Hg and left ventricular ejection fraction (LVEF) less than 50%. ResultsIn response to dobutamine echocardiography stress test, 20 patients underwent aortic valve replacement. The result of intraoperative pathology showed 11 patients were with bicuspid aortic valve malformation, 4 patients with degenerative changes, 4 patients with rheumatic disease. During the same period, 3 patients underwent atrial fibrillation ablation, 1 patient with ascending aorta replacement, 2 patients with coronary artery bypass grafting, 1 patient with mitral valvuloplasty. One patient died of multiple organ failure on the fourth day after operation. The remaining patients recovered. The patients were followed up for 3 to 37 months after operation. Heart function of majority improved to gradeⅠorⅡin 3 months after surgery. The result of echocardiogram showed prosthetic valve function was good and LVEF increased (preoperative 35.7%± 8.2% vs. postoperative 49.4%± 7.2%). One patient suffered sudden death of unknown cause in the 11th months after operation. ConclusionsFor patients whose dobutamine echocardiography stress test displayed with true severe aortic stenosis and left ventricular contractile reserve capacity, after aortic valve replacement and relief of the obstruction, the left ventricular afterload decreases significantly, the left ventricular function also improves, LVEF and the quality of life improve significantly after operation.