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主动脉瓣狭窄与非心脏手术:风险管理

Aortic Stenosis and Noncardiac Surgery: Managing the Risk.

作者信息

Pislaru Sorin V, Abel Martin D, Schaff Hartzell V, Pellikka Patricia A

出版信息

Curr Probl Cardiol. 2015 Nov;40(11):483-503. doi: 10.1016/j.cpcardiol.2015.06.003. Epub 2015 Jun 11.

Abstract

Managing the risk of noncardiac surgery in patients with aortic stenosis is a problem that is frequently confronted in clinical practice. Traditionally, patients with severe aortic stenosis were considered to be at substantial risk during noncardiac surgery, and as such, elective procedures were avoided before intervention on the aortic valve in most patients other than those who were ineligible or refused aortic valve replacement. Recent data suggest that with contemporary anesthesia and surgical techniques, the risk of noncardiac surgery is substantially lower than previously believed. We review the existent literature in the field, and propose a practical approach to complex patients.

摘要

管理主动脉瓣狭窄患者非心脏手术的风险是临床实践中经常面临的问题。传统上,严重主动脉瓣狭窄患者在非心脏手术期间被认为存在重大风险,因此,除了那些不符合条件或拒绝主动脉瓣置换的患者外,大多数患者在对主动脉瓣进行干预之前会避免择期手术。最新数据表明,采用当代麻醉和手术技术,非心脏手术的风险远低于此前认为的水平。我们回顾了该领域的现有文献,并针对复杂患者提出了一种实用方法。

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