Nurse Anesthetists

A review of aortic stenosis: an anesthetic perspective

“…The major pathophysiologic concerns with severe AS include concentric hypertrophy, decreased diastolic compliance, and a narrow balance of myocardial oxygen supply and demand. 3,4,6 The pathological consequences of AS are contributed to left ventricular outflow obstruction caused by the stenotic valve. Over time, the AV becomes more calcified and thick which worsens the outflow obstruction.…”

“…The calcification is progressive and degenerative, but also thought to be an inflammatory atherosclerotic process similar to coronary artery disease. 6 The outflow of blood through the AV during systole progressively decreases over time as the AV narrows.…”

“…4 Antibiotics are used to prevent worsening endocarditis if present. 6 Recent studies have found that statin therapy can decrease the progression of AS. However, patients with AS treated with medical therapy still have a poor prognosis.…”

“…A congenital bicuspid valve that replaces the normal tricuspid AV can lead a patient to develop AS earlier in life. 6 Other causative factors include rheumatic heart disease from group A streptococci rheumatic fever and infective endocarditis. Risk factors for AS include systemic hypertension, hypercholesterolemia, age, male gender, diabetes mellitus, cigarette smoking, metabolic syndrome, and end-stage renal disease.…”

“…Risk factors for AS include systemic hypertension, hypercholesterolemia, age, male gender, diabetes mellitus, cigarette smoking, metabolic syndrome, and end-stage renal disease. 3,4,6…”