Billig Sebastian, Hein Marc, Uhlig Moritz, Schumacher David, Thudium Marcus, Coburn Mark, Weisheit Christina K
Klinik für Anästhesiologie, Universitätsklinikum Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
Klinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
Anaesthesiologie. 2024 Mar;73(3):168-176. doi: 10.1007/s00101-024-01380-x. Epub 2024 Feb 9.
Aortic valve stenosis is a common condition that requires an anesthesiologist's in-depth knowledge of the pathophysiology, diagnostics and perioperative features of the disease. A newly diagnosed aortic valve stenosis is often initially identified from the anamnesis (dyspnea, syncope, angina pectoris) or a suspicious auscultation finding during the anesthesiologist's preoperative assessment. Interdisciplinary collaboration is essential to ensure the optimal management of these patients in the perioperative setting. An accurate anamnesis and examination during the preoperative assessment are crucial to select the most suitable anesthetic approach. Additionally, a precise understanding of the hemodynamic peculiarities associated with aortic valve stenosis is necessary. After a short summary of the overall pathophysiology of aortic valve stenosis, this review article focuses on the specific anesthetic considerations, risk factors for complications, and the perioperative management for noncardiac surgery in patients with aortic valve stenosis.
主动脉瓣狭窄是一种常见病症,需要麻醉医生深入了解该疾病的病理生理学、诊断方法及围手术期特征。新诊断出的主动脉瓣狭窄通常最初是在麻醉医生术前评估期间,从病史(呼吸困难、晕厥、心绞痛)或可疑的听诊发现中识别出来的。跨学科协作对于确保这些患者在围手术期得到最佳管理至关重要。术前评估期间准确的病史采集和检查对于选择最合适的麻醉方法至关重要。此外,有必要精确了解与主动脉瓣狭窄相关的血流动力学特点。在简要总结主动脉瓣狭窄的整体病理生理学之后,本文综述重点关注主动脉瓣狭窄患者非心脏手术的具体麻醉注意事项、并发症危险因素及围手术期管理。