What are the AHA/ACC guidelines on noncardiac surgery in patients with severe aortic stenosis (AS)?

Updated: Jul 16, 2021
  • Author: Lindsay A (Finger) Raleigh, MD; Chief Editor: Sheela Pai Cole, MD  more...
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Answer

Answer

Guidelines regarding noncardiac surgery in patients with severe AS have been published by the AHA/ACC [20] and by the European Society of Cardiology (ESC)/European Society of Anaesthesiology (ESA). [23] The AHA/ACC guidelines provides the following statements and recommendations [20] :

  • Emergency noncardiac surgery may occur in the presence of severe AS
  • For adults who meet indications for valvular intervention on the basis of symptoms and severity of stenosis, SAVR is recommended before elective noncardiac surgery to reduce perioperative risk (class I recommendation; level of evidence, C)
  • Elevated-risk elective noncardiac surgery with appropriate intraoperative and postoperative hemodynamic monitoring is reasonable to perform in patients with asymptomatic severe AS (class IIa recommendation; level of evidence, B)

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