Moderate Aortic Stenosis and Coronary Artery Bypass Grafting: Clinical Update for the Perioperative Echocardiographer.
Incidental aortic stenosis in the setting of coronary artery bypass surgery may be a perioperative challenge. The accurate assessment of the degree of aortic stenosis remains an important determinant. Although severe aortic stenosis is an indication for valve replacement, current guidelines advise a balanced approach to the management of moderate aortic stenosis in this setting. Multiple factors should be considered in a team discussion to balance risks versus benefits for the various management options in the given patient. The rapid progress in aortic valve technologies also offer alternatives for definitive management of moderate aortic stenosis in this setting that will likely become even safer in the near future.
Department of Anesthesiology, Allegheny Health Network, Temple University School of Medicine, Pittsburgh, PA;
Yasdet
Y
Maldonado
Department of Anesthesiology, Allegheny Health Network, Temple University School of Medicine, Pittsburgh, PA;
Saket
S
Singh
Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address: yiandoc@hotmail.com.
John G
JG
Augoustides
Department of Anesthesiology, Allegheny Health Network, Temple University School of Medicine, Pittsburgh, PA;
Brenda
B
MacKnight
Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Elizabeth
E
Zhou
Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Jacob T
JT
Gutsche
Department of Anesthesiology, Mayo Clinic, Scottsdale, AZ.
Harish
H
Ramakrishna
D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D006328:Cardiac Catheterization; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D004452:Echocardiography; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D019990:Perioperative Care / Q000379:methods*; D012720:Severity of Illness Index
Gorlin area; aortic stenosis; aortic valve area; continuity equation; coronary artery bypass grafting; effective orifice area; ellipse; geometric orifice area; minimally invasive; port access; pressure recovery; risk stratification; sutureless; three-dimensional imaging; transcatheter aortic valve replacement; transesophageal echocardiography