Related Experiment Video

Updated: Mar 28, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
06:26

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

1.2K

Hip Hemiarthroplasty in Two Patients with Severe Aortic Stenosis: Ethical Questions from an Anesthesiologist's

Julie R McSwain1, Jennifer R Matos, Brystol L Henderson

  • 1From the Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina.

A & a Case Reports
|December 15, 2015
PubMed

Insights

Geriatric patients with severe aortic stenosis undergoing noncardiac surgery face high risks. While anesthetic management varied, both patients died postoperatively due to comorbidities, highlighting the need for increased awareness and discussion.

Area of Science:

  • Geriatric Cardiology
  • Anesthesiology
  • Surgical Risk Assessment

Background:

  • Increasing number of elderly patients with pre-existing cardiac conditions undergoing non-cardiac surgery.
  • Severe aortic stenosis poses significant risks in the perioperative setting for geriatric populations.
  • Decision-making for surgery in these patients is complex and multifactorial.

Observation:

  • Case report of two geriatric patients with severe aortic stenosis requiring hip surgery (one urgent, one elective).
  • Employed distinct anesthetic strategies for each patient.
  • Both patients remained hemodynamically stable during the intraoperative period.

Findings:

  • Despite successful intraoperative management, both patients experienced postoperative mortality.
  • Mortality was attributed to pre-existing comorbidities rather than surgical or anesthetic complications.
  • The study highlights the challenges in managing geriatric patients with severe aortic stenosis.

Implications:

  • Lack of specific published guidelines for managing geriatric patients with severe aortic stenosis undergoing non-cardiac surgery.
  • This case series aims to raise awareness and stimulate discussion among clinicians.
  • Emphasizes the critical role of managing comorbidities in the postoperative care of high-risk geriatric surgical patients.

More Related Videos

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement08:50

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

12.4K
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots12:17

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

Published on: May 21, 2017

12.0K

Related Concept Videos

Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
582
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
549
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
447
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
424
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
562
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
1.2K