[主动脉瓣狭窄的麻醉:非心脏手术中主动脉瓣狭窄患者的麻醉管理]。

Die Anaesthesiologie Pub Date : 2024-03-01 Epub Date: 2024-02-09 DOI:10.1007/s00101-024-01380-x
Sebastian Billig, Marc Hein, Moritz Uhlig, David Schumacher, Marcus Thudium, Mark Coburn, Christina K Weisheit
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引用次数: 0

摘要

主动脉瓣狭窄是一种常见病,需要麻醉医生深入了解该病的病理生理学、诊断学和围手术期特征。新诊断出的主动脉瓣狭窄通常最初是在麻醉医师进行术前评估时从病史(呼吸困难、晕厥、心绞痛)或可疑的听诊结果中发现的。要确保在围手术期对这些患者进行最佳管理,跨学科合作至关重要。术前评估中准确的病史和检查对于选择最合适的麻醉方法至关重要。此外,准确了解与主动脉瓣狭窄相关的血流动力学特性也是必要的。在对主动脉瓣狭窄的整体病理生理学进行简短总结后,这篇综述文章将重点讨论主动脉瓣狭窄患者的具体麻醉注意事项、并发症的风险因素以及非心脏手术的围手术期管理。
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[Anesthesia for aortic valve stenosis : Anesthesiological management of patients with aortic valve stenosis during noncardiac surgery].

Aortic valve stenosis is a common condition that requires an anesthesiologist's in-depth knowledge of the pathophysiology, diagnostics and perioperative features of the disease. A newly diagnosed aortic valve stenosis is often initially identified from the anamnesis (dyspnea, syncope, angina pectoris) or a suspicious auscultation finding during the anesthesiologist's preoperative assessment. Interdisciplinary collaboration is essential to ensure the optimal management of these patients in the perioperative setting. An accurate anamnesis and examination during the preoperative assessment are crucial to select the most suitable anesthetic approach. Additionally, a precise understanding of the hemodynamic peculiarities associated with aortic valve stenosis is necessary. After a short summary of the overall pathophysiology of aortic valve stenosis, this review article focuses on the specific anesthetic considerations, risk factors for complications, and the perioperative management for noncardiac surgery in patients with aortic valve stenosis.

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