MAJOR NON-CARDIAC SURGERY IN PATIENTS WITH AORTIC STENOSIS - SAME AS 20 YEARS AGO?


Sorin Pislaru, M.D., Ph.D., Mayo Clinic College of Medicine, Rochester, MN, USA

Severe aortic stenosis has been long recognized as a risk factor for perioperative mortality and morbidity. Current ACC/AHA Guidelines recommend that elective noncardiac surgery be postponed for AS patients until after aortic valve surgery, due to an estimated mortality risk of noncardiac surgery at approximately 10%. However, these recommendations are based on studies that are now couple decades old, echocardiographic criteria for defining severe aortic stenosis have since changed, and improvements in surgical and anesthesia techniques have led to a decrease in overall surgical mortality and morbidity. Recent data suggest the perioperative risk associated with severe aortic stenosis in the contemporary era is significantly lower than originally described.