Jalali Yashar, Jalali Monika, Števlík Ján
Faculty of Medicine, Comenius University in Bratislava, 5th Department of Internal Medicine, University Hospital Bratislava, Ružinov, Špitálska 24, 813 72 Bratislava, Slovakia, and Ružinovská 4810/6, 821 01 Bratislava, Slovakia.
J Clin Med. 2024 May 30;13(11):3240. doi: 10.3390/jcm13113240.
Postoperative cardiovascular complications (either in a hospital or within 30 days after the operation) are among the most common problems with non-cardiac surgeries (NCSs). Pre-existing cardiac comorbidities add significant risk to the development of such complications. Valvular heart disease (VHD), a rather frequent cardiac comorbidity (especially in the elderly population), can pose serious life-threatening peri-/postoperative complications. Being familiar with the recommended perioperative management of patients with VHD or an implanted prosthetic heart valve who are scheduled for NCS is of great importance in daily clinical practice. Although recently published guidelines by the European Society of Cardiology (ESC) and the American College of Cardiology and American Heart Association (ACC/AHA) for the management of VHD and perioperative management of patients undergoing NCS addresses the mentioned problem, a comprehensive review of the guidelines that provides an easy-to-use summary of the recommendations and their similarities and differences is missing in the published literature. In this review article, we summarize all of the relevant important information based on the latest data published in both guidelines needed for practical decision-making in the perioperative management of patients with VHD or after valvular repair (with prosthetic heart valve) who are scheduled for NCS.
术后心血管并发症(无论是在住院期间还是术后30天内)是非心脏手术(NCS)中最常见的问题之一。术前存在的心脏合并症会显著增加此类并发症发生的风险。瓣膜性心脏病(VHD)是一种相当常见的心脏合并症(尤其是在老年人群中),可导致严重的危及生命的围手术期/术后并发症。熟悉针对计划进行非心脏手术的VHD患者或植入人工心脏瓣膜患者的推荐围手术期管理,在日常临床实践中非常重要。尽管欧洲心脏病学会(ESC)以及美国心脏病学会和美国心脏协会(ACC/AHA)最近发布了关于VHD管理和非心脏手术患者围手术期管理的指南,解决了上述问题,但已发表的文献中缺少对这些指南的全面综述,该综述应提供易于使用的建议总结及其异同。在这篇综述文章中,我们根据这两个指南中发表的最新数据,总结了计划进行非心脏手术的VHD患者或瓣膜修复(使用人工心脏瓣膜)后患者围手术期管理实际决策所需的所有相关重要信息。