What the cardiac surgeon needs to know prior to aortic valve surgery: impact of echocardiography

Abstract

Echocardiographic assessment prior to valve surgery is crucial for clinical decision making, timing of surgery, planning the adequate surgical therapy and predicting the patient's outcome. Description of transvalvular velocities is not enough for sending a patient to the operating room. There are specific functional and morphological characteristics of each valve dysfunction that have to be addressed by the echocardiographer prior to surgery. Evaluation of the aortic valve, annulus, root, ascending aorta, left ventricular outflow tract and left ventricular function are important. In knowing these characteristics the surgeon may choose the appropriate valve and operation techniques and assess the need for additional surgical procedures. A detailed evaluation of valve morphology and function in context with cardiac hemodynamics should be achieved during echocardiography. This step-by-step evaluation allows the correct diagnosis and classification of patient's outcome. In conclusion, an echohemodynamic approach enables the cardiac surgeon to plan and perform the adequate surgical procedure.

Conservative treatment of a left atrial intramural hematoma after left atrial thrombus resection and concomitant mitral valve replacement - case report

“…Pre- [11] and intraoperative [12] echocardiography of the heart is an indispensible examination for patients undergoing cardiac valve surgery. Whereas transthoracal echocardiography is less invasive and more convenient to the patient, several studies have demonstrated transesophageal echocardiography to be superior for assessing possible sources of cardiac embolism [13], such as intracardiac thrombi or intramural lesions [14].…”