Valvular heart disease surgery: Difference between revisions

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==2008 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease (DO NOT EDIT)<ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, ''et al.'' |title=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 |journal=Circulation |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=}}</ref>==
===Diagnosis of Coronary Artery Disease before the Surgery(DO NOT EDIT) <ref name="pmid16880336">{{cite journal |author=Bonow RO, Carabello BA, Kanu C, ''et al.'' |title=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): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons |journal=Circulation |volume=114 |issue=5 |pages=e84–231 |year=2006 |month=August |pmid=16880336 |doi=10.1161/CIRCULATIONAHA.106.176857 |url=}}</ref>===
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' [[Coronary angiography]] is indicated before valve surgery (including [[infective endocarditis]]) or [[mitral balloon commissurotomy]]                                      in patients with [[chest pain]], other objective evidence of [[ischemia]], decreased [[LV function|LV systolic function]], history of [[CAD]], or [[coronary                                      risk factors]] (including age). Patients undergoing [[mitral balloon valvotomy]] need not undergo [[coronary angiography]] solely on                                      the basis of [[coronary risk factors]]. ([[ACC AHA guidelines classification scheme#Level of Evidence|''Level of evidence: C'']])<nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' [[Coronary angiography]] is indicated in patients with apparently mild to moderate valvular heart disease but with progressive                                      [[angina]] (Canadian Heart Association functional Class II or greater), objective evidence of [[ischemia]], decreased [[LV function|LV systolic                                      function]], or overt [[congestive heart failure]]. ([[ACC AHA guidelines classification scheme#Level of Evidence|''Level of evidence: C'']])<nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' [[Coronary angiography]] should be performed before valve surgery in men aged 35 years or older, [[premenopausal]] women aged 35 years                                      or older who have [[coronary risk factors]], and [[postmenopausal]] women. ([[ACC AHA guidelines classification scheme#Level of Evidence|''Level of evidence: C'']])<nowiki>"</nowiki>
|}
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]]
|-
| bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' [[Coronary angiography]] is not indicated in young patients undergoing nonemergency valve surgery when no further hemodynamic                                      assessment by catheterization is deemed necessary and there are no [[coronary risk factors]], no history of [[CAD]], and no evidence                                      of [[ischemia]]. ([[ACC AHA guidelines classification scheme#Level of Evidence|''Level of evidence C'']])<nowiki>"</nowiki>
|-
| bgcolor="LightCoral"|<nowiki>"</nowiki>'''2.''' Patients should not undergo [[coronary angiography]] before valve surgery if they are severely hemodynamically unstable. ([[ACC AHA guidelines classification scheme#Level of Evidence|''Level of evidence C'']])<nowiki>"</nowiki>
|}
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Surgery without [[coronary angiography]] is reasonable for patients having emergency valve surgery for acute valve regurgitation,                                [[aortic root]] disease, or [[infective endocarditis]]. ([[ACC AHA guidelines classification scheme#Level of Evidence|''Level of evidence C'']])<nowiki>"</nowiki>
|}
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
|-
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[Coronary angiography]] may be considered for patients undergoing catheterization to confirm the severity of valve [[lesions]]                                before valve surgery without pre-existing evidence of [[CAD]], multiple [[coronary risk factors]], or advanced age. ([[ACC AHA guidelines classification scheme#Level of Evidence|''Level of evidence C'']])<nowiki>"</nowiki>
|}
==Sources==
*2008 and incorporated 2006 ACC/AHA Guidelines incorporated into the 2006 guidelines for the management of patients with valvular heart disease <ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, ''et al.'' |title=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 |journal=Circulation |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=}}</ref>
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 15:22, 7 November 2012

Valvular heart disease Microchapters

Patient Information

Classification

Aortic stenosis
Aortic regurgitation
Mitral stenosis
Mitral valve prolapse
Mitral regurgitation
Tricuspid stenosis
Tricuspid regurgitation
Pulmonary stenosis
Pulmonary regurgitation

Differential Diagnosis

Please help WikiDoc by adding content here. It's easy! Click here to learn about editing.

2008 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease (DO NOT EDIT)[1]

Diagnosis of Coronary Artery Disease before the Surgery(DO NOT EDIT) [2]

Class I
"1. Coronary angiography is indicated before valve surgery (including infective endocarditis) or mitral balloon commissurotomy in patients with chest pain, other objective evidence of ischemia, decreased LV systolic function, history of CAD, or coronary risk factors (including age). Patients undergoing mitral balloon valvotomy need not undergo coronary angiography solely on the basis of coronary risk factors. (Level of evidence: C)"
"2. Coronary angiography is indicated in patients with apparently mild to moderate valvular heart disease but with progressive angina (Canadian Heart Association functional Class II or greater), objective evidence of ischemia, decreased LV systolic function, or overt congestive heart failure. (Level of evidence: C)"
"3. Coronary angiography should be performed before valve surgery in men aged 35 years or older, premenopausal women aged 35 years or older who have coronary risk factors, and postmenopausal women. (Level of evidence: C)"
Class III
"1. Coronary angiography is not indicated in young patients undergoing nonemergency valve surgery when no further hemodynamic assessment by catheterization is deemed necessary and there are no coronary risk factors, no history of CAD, and no evidence of ischemia. (Level of evidence C)"
"2. Patients should not undergo coronary angiography before valve surgery if they are severely hemodynamically unstable. (Level of evidence C)"
Class IIa
"1. Surgery without coronary angiography is reasonable for patients having emergency valve surgery for acute valve regurgitation, aortic root disease, or infective endocarditis. (Level of evidence C)"
Class IIb
"1. Coronary angiography may be considered for patients undergoing catheterization to confirm the severity of valve lesions before valve surgery without pre-existing evidence of CAD, multiple coronary risk factors, or advanced age. (Level of evidence C)"

Sources

  • 2008 and incorporated 2006 ACC/AHA Guidelines incorporated into the 2006 guidelines for the management of patients with valvular heart disease [1]

References

  1. ↑ 1.0 1.1 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)
  2. ↑ Bonow RO, Carabello BA, Kanu C; et al. (2006). "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): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons". Circulation. 114 (5): e84–231. doi:10.1161/CIRCULATIONAHA.106.176857. PMID 16880336. Unknown parameter |month= ignored (help)
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