Non-cardiac surgery and obstetric analgesia in the patient with valvular disease: anesthetic considerations
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Marcel Vercauteren

Department of Anesthesia, Antwerp University Hospital, Belgium

Abstract

As patients are reaching higher ages now but also due to medical progress, progressively more patients present nowadays with valvular lesions for non-cardiac surgical procedures. Some patients may benefit from a regional anesthetic technique while others will be best managed with stress-free general anesthesia. The aim should not be to normalize the hemodynamics but to keep the patient as stable as possible as compared to the preoperative condition. Although many patients will have combined defects, this overview will focus on the most common individual defects, their etiology, symptoms, physiopathology and anesthetic management. Special attention will be paid to the obstetric population which is getting older as well. This is a challenge for obstetricians and anesthesiologists because of the physiological changes during and after pregnancy and the hemodynamic impact of labor, oxytocics, tocolytics, pain and anesthesia.

Key words: cardiac, valvular, obstetric, anesthesia, regional