Aortic regurgitation surgery preoperative evaluation
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Aortic Insufficiency Surgery | |
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Treatment | |
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For the WikiPatient page for this topic, click here; For the main page of aortic insufficiency, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Varun Kumar, M.B.B.S., Lakshmi Gopalakrishnan, M.B.B.S., Mohammed A. Sbeih, M.D.[3]; Usama Talib, BSc, MD [4]
Related Key Words and Synonyms: Aortic valve replacement.
Aortic Insufficiency Preoperative Evaluation
The patient may need to have some tests before the procedure. After the diagnosis of aortic insufficiency, the general health of the patient should be assessed and the most appropriate treatment should be recommended. Some of the tests that can be done before the procedure include: [1][2][3][4][5][6][7]
- Echocardiogram (Doppler echocardiogram).
- Cardiac catheterization.
- Chest X-ray.
- Computed tomography (CT) scan.
- Electrocardiogram (ECG).
- Electrophysiology tests.
- Exercise tests.
- Holter monitor.
- Magnetic resonance imaging (MRI).
Cardiac catheterization in patients with chronic aortic insufficiency is recommended if the noninvasive diagnostic tests are inconclusive, or if the patient is at risk of coronary heart disease and the coronary anatomy should be assessed.
Before the surgery:
- The surgeon needs to know if the patient is taking any drugs, supplements, or herbs before the procedure.
- The patient may be able to store blood in the blood bank for transfusions during and after the surgery. The family members can also donate blood (autologous donation).
- For the 2-week period before surgery, the patient should be asked to stop taking drugs that make it harder for the blood to clot. These might cause increased bleeding during the surgery. Some of these drugs are aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn).
- The day before the surgery, the patient should shower and shampoo well and wash the whole body below the neck with a special soap.
- The patient may also be asked to take an antibiotic to guard against infection.
- The patient should be informed which drugs he or she should still take on the day of the surgery.
- The patient should stop smoking.
On the day of the surgery:
- An intravenous (IV) line will be placed into a blood vessel in the patient's arm or chest to give fluids and medicines.
- The patient should be asked not to drink or eat anything after midnight the night before surgery. This includes chewing gum and using breath mints. The patient can rinse mouth with water if it feels dry without swallowing.
- Make sure that the patient is taking the drugs that he or she needs to take with a small sip of water.
- Hair near the incision site may be shaved immediately before the surgery.
- The patient should be informed when to arrive to hospital on the day of the surgery.
References
- ↑ Bonow RO, Carabello B, de Leon AC, Edmunds LH, Fedderly BJ, Freed MD; et al. (1998). "ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease. Executive Summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Valvular Heart Disease)". J Heart Valve Dis. 7 (6): 672–707. PMID 9870202.
- ↑ Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA; et al. (2014). "2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". J Thorac Cardiovasc Surg. 148 (1): e1–e132. doi:10.1016/j.jtcvs.2014.05.014. PMID 24939033.
- ↑ Petit CJ, Gao K, Goldstein BH, Lang SM, Gillespie SE, Kim SI; et al. (2016). "Relation of Aortic Valve Morphologic Characteristics to Aortic Valve Insufficiency and Residual Stenosis in Children With Congenital Aortic Stenosis Undergoing Balloon Valvuloplasty". Am J Cardiol. 117 (6): 972–9. doi:10.1016/j.amjcard.2015.12.034. PMID 26805657.
- ↑ Bonow RO, Carabello BA, Chatterjee K; et al. (2008). "2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter
|month=ignored (help) - ↑ Desjardins VA, Enriquez-Sarano M, Tajik AJ, Bailey KR, Seward JB (1996). "Intensity of murmurs correlates with severity of valvular regurgitation". Am J Med. 100 (2): 149–56. PMID 8629648.
- ↑ Grande RD, Katz WE (2011). "Acute aortic regurgitation secondary to disk embolization of a Björk-Shiley prosthetic aortic valve". J Am Soc Echocardiogr. 24 (3): 350.e5–6. doi:10.1016/j.echo.2010.07.001. PMID 20708374.
- ↑ Miller JG, Li M, Mazilu D, Hunt T, Horvath KA (2016). "Robot-assisted real-time magnetic resonance image-guided transcatheter aortic valve replacement". J Thorac Cardiovasc Surg. 151 (5): 1407–12. doi:10.1016/j.jtcvs.2015.11.047. PMC 4834269. PMID 26778373.