This case report illustrates the application of ESC guidelines by prioritizing aortic valve replacement before elective non-cardiac surgery in a patient with severe aortic stenosis.
Supports ESC-guided AVR prioritization before elective noncardiac surgery in severe AS; leaves open need for prospective outcome data.
Patients with valvular heart disease are at increased risk of perioperative cardiovascular complications during non-cardiac surgery. The risk is highly variable, according to the type of valvular heart disease and severity of non-cardiac surgery. In the case of elective non-cardiac surgery, the presence of symptoms is crucial for decision. In asymptomatic patients, non-cardiac surgery with small or moderate risk can be performed safely. We presented a case of a 68-year-old patient who had severe aortic stenosis that required surgical treatment, aortic valve replacement, whereas on the other hand he also had a significant inguinal hernia, which also required surgical treatment. The dilemma was what to do first - aortic valve replacement or hernioplasty. According to the new guidelines of the European society of cardiology for the treatment of patients who have valvular heart disease and are sent to non-cardiac surgery, the patient was sent to have aortic valve replacement first, and after complete recovery from cardiac surgery, he was submitted for hernioplasty.
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Janković et al. (2014) studied this question.
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