Key result
Aortic valve intervention before major non-cardiac surgery reduces postoperative heart failure in symptomatic severe AS.
Why the study?
Perioperative mortality in aortic stenosis may be decreasing, and recent guidelines have updated recommendations for asymptomatic and symptomatic patients undergoing non-cardiac surgery.
How should patients with severe aortic stenosis be managed perioperatively when undergoing non-cardiac surgery?
How should patients with severe aortic stenosis be managed perioperatively when undergoing non-cardiac surgery?
Asymptomatic severe aortic stenosis patients can safely undergo major non-cardiac surgery with close monitoring, whereas symptomatic patients require prior aortic valve intervention to reduce postoperative heart failure and improve survival.
Supports pre-op intervention in symptomatic severe AS; leaves open prospective validation for asymptomatic monitoring strategies.
Aortic stenosis is one of the most common cardiac valve pathologies in the world and its prevalence increases with age. Although previously associated with increased perioperative mortality, more recent studies suggest that mortality rates may be decreasing. Recent guidelines suggest that major non-cardiac surgery can be performed safely in asymptomatic severe aortic stenosis patients with close hemodynamic monitoring. Among symptomatic patients, the guidelines recommend aortic valve intervention prior to major non-cardiac surgery because of a reduction in the incidence of postoperative heart failure and improved rates of long-term overall survival. This review provides a comprehensive and contemporary review of the perioperative management of patients with severe aortic valve stenosis.
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Herrera et al. (2023) conducted a review in Aortic stenosis. Aortic valve replacement (AVR) vs. No prior AVR was evaluated. Aortic valve intervention prior to major non-cardiac surgery is recommended for symptomatic patients with severe aortic stenosis to reduce postoperative heart failure and improve long-term survival.
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