Anesthetic Considerations for Patients with Advanced Valvular Heart Disease Undergoing Noncardiac Surgery

Frogel, Jonathan; Galusca, Dragos

doi:10.1016/j.anclin.2010.01.008

Cited by 38 publications

(26 citation statements)

References 47 publications

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“…They recommended assessing of platelet functions and usage of desmopressin to avoid increased blood loss in patients with reduced platelet functions. Among perioperative cautions for the patient with AS, careful manipulation of hemodynamics is crucial (Frogel & Galusca, 2010). Main goals to decrease the perioperative cardiovascular risk are to maintain sinus rhythm, a relatively slow heart rate, and adequate preload and afterload (Frogel & Galusca, 2010).…”

Section: Evaluation and Managementmentioning

confidence: 99%

“…Among perioperative cautions for the patient with AS, careful manipulation of hemodynamics is crucial (Frogel & Galusca, 2010). Main goals to decrease the perioperative cardiovascular risk are to maintain sinus rhythm, a relatively slow heart rate, and adequate preload and afterload (Frogel & Galusca, 2010). In this context, a slower heart rate decreases myocardial oxygen demand and increases coronary perfusion time.…”

Section: Evaluation and Managementmentioning

confidence: 99%

“…In this context, a slower heart rate decreases myocardial oxygen demand and increases coronary perfusion time. Routine antibiotic prophylaxis is not recommended unless the patient has a previous history of infective endocarditis (Frogel & Galusca, 2010). Regarding anesthetic premedication, anticholinergics may cause tachycardia in a dose dependent manner and careful titration of sedation is crucial because oversedation may cause hypotension and undersedation may increase the sympathetic tone (Frogel & Galusca, 2010).…”

Section: Evaluation and Managementmentioning

confidence: 99%

“…Because of the risk of serious arrhythmias, a defibrillator should be readily available and placed on the patient before sterile draping. Ideal heart rate is in the range of 60 to 70 beats per minute and bradicardia should be avoided especially in the elderly patients who may have predisposition to it (Frogel & Galusca, 2010). As atrial systole is necessary for maximal LV preload, maintenance of normal sinus rhythm is very important.…”

Section: Evaluation and Managementmentioning

confidence: 99%

“…As atrial systole is necessary for maximal LV preload, maintenance of normal sinus rhythm is very important. Adequate hydration is very important as well, since patients with AS are preload dependent (Frogel & Galusca, 2010). Elderly patients and patients with central nervous system disorders affecting sensation of thirst have tendency to develop dehydration and need careful evaluation of hydration status.…”

Section: Evaluation and Managementmentioning

confidence: 99%

See 4 more Smart Citations

Geriatric Aspects of Aortic Stenosis

Tufan¹,

Öz²,

Sayın³

et al. 2011

Aortic Valve Stenosis - Current View on Diagnostics and Treatment

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Section: Evaluation and Managementmentioning

confidence: 99%

Section: Evaluation and Managementmentioning

confidence: 99%

Section: Evaluation and Managementmentioning

confidence: 99%

Section: Evaluation and Managementmentioning

confidence: 99%

Section: Evaluation and Managementmentioning

confidence: 99%

See 3 more Smart Citations

Geriatric Aspects of Aortic Stenosis

Tufan¹,

Öz²,

Sayın³

et al. 2011

Aortic Valve Stenosis - Current View on Diagnostics and Treatment

View full text Add to dashboard Cite

Impact of focused cardiac and lung ultrasound screening performed by a junior doctor during admission to the surgical ward on patients before emergency non‐cardiac surgery: A pilot prospective observational study

Wong

Vijayakumar

Canty

et al. 2022

Australas J Ultrason Med

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Purpose To assess whether pre‐operative focused cardiac ultrasound and lung ultrasound screening performed by a junior doctor can change diagnosis and clinical management of patients aged ≥65 years undergoing emergency, non‐cardiac surgery. Method This pilot prospective observational study included patients scheduled for emergency, non‐cardiac surgery. The treating team completed a diagnosis and management plan before and after focused cardiac and lung ultrasound, which was performed by a junior doctor. Changes to diagnosis and management after ultrasound were recorded. Ultrasound images were assessed for image and diagnostic interpretation by an independent expert. Results There was a total of 57 patients at age 77 ± 8 years. Cardiopulmonary pathology was suspected after clinical assessment in 28% vs. 72% after ultrasound (including abnormal haemodynamic state in 61%, valvular lesions in 32%, acute pulmonary oedema/interstitial syndrome in 9% and bilateral pleural effusions in 2%). In 67% of patients, the perioperative management was changed. The changes were in fluid therapy in 30%, cardiology consultation in 7%, formal in‐ or out‐patient, transthoracic echocardiography in 11% and 30% respectively. Discussion The impact of pre‐operative focused cardiac and lung ultrasound on diagnosis and management of patients on the hospital ward before emergency non‐cardiac surgery by a junior doctor was comparable to previous studies of anaesthetists experienced in focused ultrasound. However, the ability to recognise when image quality is insufficient for diagnosis is an important consideration for novice sonographers. Conclusions Focused cardiac and lung ultrasound examination by a junior doctor is feasible and may change preoperative diagnosis and management in patients of 65 years or older, admitted for emergency non‐cardiac surgery.

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Valvular Heart Disease

Arora¹,

Gollapudi²

2019

The Perioperative Medicine Consult Handbook

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Anesthetic Considerations for Patients with Advanced Valvular Heart Disease Undergoing Noncardiac Surgery

Cited by 38 publications

References 47 publications

Geriatric Aspects of Aortic Stenosis

Geriatric Aspects of Aortic Stenosis

Impact of focused cardiac and lung ultrasound screening performed by a junior doctor during admission to the surgical ward on patients before emergency non‐cardiac surgery: A pilot prospective observational study

Valvular Heart Disease

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