Biomaterial Database

Anesthetic considerations for patients with advanced valvular heart disease undergoing noncardiac surgery. 2010

Jonathan Frogel, and Dragos Galusca

Department of Anesthesiology, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA. jfrogel1@hfhs.org

Patients with valvular heart disease represent a growing segment of the population and can present major challenges to clinical anesthesiologists. This review focuses on patients with advanced left-sided valvular disease undergoing noncardiac surgery. The pathophysiology and anesthetic implications of aortic stenosis and insufficiency and mitral stenosis and insufficiency are discussed, with a focus on optimizing perioperative management and decision making for patients with these conditions.

UI	MeSH Term	Description	Entries
D008944	Mitral Valve Insufficiency	Backflow of blood from the LEFT VENTRICLE into the LEFT ATRIUM due to imperfect closure of the MITRAL VALVE. This can lead to mitral valve regurgitation.	Mitral Incompetence,Mitral Regurgitation,Mitral Valve Incompetence,Mitral Insufficiency,Mitral Valve Regurgitation,Incompetence, Mitral,Incompetence, Mitral Valve,Insufficiency, Mitral,Insufficiency, Mitral Valve,Regurgitation, Mitral,Regurgitation, Mitral Valve,Valve Incompetence, Mitral,Valve Insufficiency, Mitral,Valve Regurgitation, Mitral
D008946	Mitral Valve Stenosis	Narrowing of the passage through the MITRAL VALVE due to FIBROSIS, and CALCINOSIS in the leaflets and chordal areas. This elevates the left atrial pressure which, in turn, raises pulmonary venous and capillary pressure leading to bouts of DYSPNEA and TACHYCARDIA during physical exertion. RHEUMATIC FEVER is its primary cause.	Mitral Stenosis,Mitral Stenoses,Mitral Valve Stenoses,Stenoses, Mitral,Stenoses, Mitral Valve,Stenosis, Mitral,Stenosis, Mitral Valve,Valve Stenoses, Mitral,Valve Stenosis, Mitral
D006349	Heart Valve Diseases	Pathological conditions involving any of the various HEART VALVES and the associated structures (PAPILLARY MUSCLES and CHORDAE TENDINEAE).	Heart Valvular Disease,Valvular Heart Diseases,Disease, Heart Valvular,Heart Disease, Valvular,Heart Valve Disease,Heart Valvular Diseases,Valve Disease, Heart,Valvular Disease, Heart,Valvular Heart Disease
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000758	Anesthesia	A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.
D001024	Aortic Valve Stenosis	A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.	Aortic Stenosis,Aortic Valve Stenoses,Stenoses, Aortic,Stenoses, Aortic Valve,Stenosis, Aortic,Stenosis, Aortic Valve,Valve Stenoses, Aortic,Valve Stenosis, Aortic
D013514	Surgical Procedures, Operative	Operations carried out for the correction of deformities and defects, repair of injuries, and diagnosis and cure of certain diseases. (Taber, 18th ed.).	Surgical Procedures,Ghost Surgery,Operative Procedures,Operative Surgical Procedure,Operative Surgical Procedures,Procedure, Operative Surgical,Procedures, Operative Surgical,Surgery, Ghost,Surgical Procedure, Operative,Operative Procedure,Procedure, Operative,Procedure, Surgical,Procedures, Operative,Procedures, Surgical,Surgical Procedure
D019990	Perioperative Care	Interventions to provide care prior to, during, and immediately after surgery.	Care, Perioperative