Key result
Anaesthetic management of patients with valvular heart disease requires meticulous fluid optimization and close haemodynamic monitoring to prevent major reductions in cardiac output and achieve good clinical outcomes.
A thorough understanding of the pathophysiology of valvular heart disease is essential for planning anaesthesia and perioperative care to achieve good clinical outcomes in non-cardiac surgeries.
Supports haemodynamic vigilance in valvular disease anaesthesia; leaves open prospective validation for non-cardiac surgery.
Valvular heart disease presents as mixed spectrum lesion in healthcare settings in the third-world and developing countries. Rheumatic heart disease still forms the bulk of the aetiopathology of valve lesions. Mitral and aortic valve lesions top the list of valvular pathology. A thorough understanding of the pathophysiology of valvular heart disease is essential while planning anaesthesia and perioperative care for such patients. Meticulous use of optimal fluids, close monitoring of the changing haemodynamics and avoidance of situations that can cause major reduction of cardiac output and fluid shifts are mandatory to achieve good clinical outcome. We searched MEDLINE using combinations of the following: anaesthesia, aortic, mitral, regurgitation, stenosis and valvular heart disease. We also hand searched textbooks and articles on valvular heart disease and anaesthesia. This article mainly focuses on the understanding the pathophysiology of valvular heart disease in patients presenting for non-cardiac surgeries in secondary and tertiary care setting.
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Paul et al. (2017) conducted a review in Valvular heart disease. Anaesthetic management was evaluated. Anaesthetic management of patients with valvular heart disease requires meticulous fluid optimization and close haemodynamic monitoring to prevent major reductions in cardiac output and achieve good clinical outcomes.
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