The preoperative assessment of patients with valvular heart disease as a comorbidity

Area of Science:

• Cardiology
• Cardiac Surgery
• Anesthesiology

Background:

• Valvular heart disease necessitates careful preoperative assessment and management for successful surgical outcomes.
• Management strategies vary significantly based on the specific type of valvular disease (aortic stenosis, regurgitation; mitral stenosis, regurgitation, prolapse).

Purpose of the Study:

• To outline criteria for evaluating valvular disease severity and surgical risk.
• To provide recommendations for intraoperative monitoring and perioperative management of hemodynamic disturbances.
• To discuss bacterial endocarditis prophylaxis and management of anticoagulation therapy in this patient population.

Main Methods:

• Review and synthesis of current guidelines and literature on preoperative evaluation and management of valvular heart disease.
• Development of criteria for assessing disease severity and surgical risk.
• Formulation of recommendations for intraoperative monitoring and perioperative treatment.
• Discussion of specific considerations for bacterial endocarditis prophylaxis and anticoagulation management.

Main Results:

• Surgical risk is directly proportional to the severity of valvular disease and the extent of non-cardiac surgery.
• Specific recommendations are provided for intraoperative hemodynamic monitoring and perioperative management of hypotension and tachycardia.
• Guidelines for bacterial endocarditis prophylaxis and management of oral anticoagulation therapy are presented.

Conclusions:

• A comprehensive, individualized preoperative approach is essential for patients with valvular heart disease undergoing surgery.
• Optimized perioperative management, including hemodynamic monitoring and targeted interventions, improves surgical outcomes.
• Prophylaxis against bacterial endocarditis and careful management of anticoagulation are critical components of preoperative preparation.