Herrera Roberto A, Smith Mark M, Mauermann William J, Nkomo Vuyisile T, Luis Sushil Allen
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States.
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States.
Front Cardiovasc Med. 2023 Apr 6;10:1145290. doi: 10.3389/fcvm.2023.1145290. eCollection 2023.
Aortic stenosis is one of the most common cardiac valve pathologies in the world and its prevalence increases with age. Although previously associated with increased perioperative mortality, more recent studies suggest that mortality rates may be decreasing. Recent guidelines suggest that major non-cardiac surgery can be performed safely in asymptomatic severe aortic stenosis patients with close hemodynamic monitoring. Among symptomatic patients, the guidelines recommend aortic valve intervention prior to major non-cardiac surgery because of a reduction in the incidence of postoperative heart failure and improved rates of long-term overall survival. This review provides a comprehensive and contemporary review of the perioperative management of patients with severe aortic valve stenosis.
主动脉瓣狭窄是全球最常见的心脏瓣膜疾病之一,其患病率随年龄增长而增加。尽管此前认为其与围手术期死亡率增加有关,但最近的研究表明死亡率可能正在下降。最新指南建议,在严密的血流动力学监测下,无症状的重度主动脉瓣狭窄患者可以安全地进行非心脏大手术。对于有症状的患者,指南建议在非心脏大手术前进行主动脉瓣干预,因为这可降低术后心力衰竭的发生率并提高长期总体生存率。本综述对重度主动脉瓣狭窄患者的围手术期管理进行了全面且与时俱进的回顾。