What are the AHA/ACC guidelines for the preoperative assessment of aortic stenosis (AS) in noncardiac surgery patients with valvular heart disease?

Updated: Jul 15, 2019
  • Author: Lindsay A (Finger) Raleigh, MD; Chief Editor: Sheela Pai Cole, MD  more...
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Answer

Answer

The 2014 AHA/ACC guideline for the management of patients with valvular heart disease stated that “TTE is indicated in patients with signs or symptoms of AS or a bicuspid aortic valve for accurate diagnosis of the cause of AS, hemodynamic severity, LV size and systolic function, and for determining prognosis and timing of valve intervention.” [8]  Cardiac catheterization for assessment of aortic stenosis was recommended only if noninvasive data are nondiagnostic or if there is a discrepancy between clinical and echocardiographic evaluation.

Similarly, the 2014 AHA/ACC guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery recommended that “patients with clinically suspected moderate or greater degrees of valvular stenosis or regurgitation should undergo preoperative echocardiography if there has been either 1) no prior echocardiography within one year or 2) a significant change in clinical status or physical examination since the last evaluation.” [18]


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