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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Core competency review: aortic stenosis and noncardiac surgery
Douglas E Wright1, Daniel P Hunt
1Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Journal of Hospital Medicine
|June 27, 2012
Summary
Severe aortic stenosis (AS) significantly increases surgical risks, with mortality up to 14%. This review assesses diagnostic methods for AS severity and perioperative risks in surgical patients.
Area of Science:
- Cardiology
- Cardiac Surgery
- Diagnostic Imaging
Background:
- Aortic stenosis (AS) is a critical valvular heart disease.
- Severe AS presents significant perioperative risks, including up to 14% mortality.
- Accurate AS assessment is vital for surgical patient management.
Purpose of the Study:
- To review the diagnostic accuracy of clinical evaluation for AS.
- To assess the role of echocardiography in determining AS severity.
- To summarize perioperative risks associated with AS in surgical candidates.
Main Methods:
- Literature review of studies on AS diagnosis and perioperative outcomes.
- Analysis of the utility of history and physical examination in AS detection.
- Evaluation of echocardiography's role in AS severity assessment.
- Synthesis of current knowledge on AS pathophysiology and surgical risk.
Main Results:
- Clinical assessment has limitations in accurately detecting and grading AS severity.
- Echocardiography is the primary imaging modality for AS assessment.
- Patients with severe AS face substantially elevated perioperative risks.
- Understanding AS pathophysiology is key to managing surgical risk.
Conclusions:
- Accurate diagnosis and severity grading of AS are crucial for surgical planning.
- Echocardiography plays a pivotal role in guiding perioperative management of AS patients.
- Mitigation strategies are essential to reduce the high mortality associated with severe AS during surgery.
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