1/8
You are asked to preoperatively assess a patient with known primary severe mitral regurgitation for an hip replacement
Which of the following new findings might result in you postponing surgery:
Dilated LV
Impaired LV sys fxn
Pulmonary HTN
New Afib
You are asked to preoperatively assess a patient with known primary severe mitral regurgitation for an hip replacement
Which of the following new findings might result in you postponing surgery:
Dilated LV
Impaired LV sys fxn
Pulmonary HTN
New Afib
2/8
Answer:
Any/all of the above
If known severe MR – these are the NEW findings that should prompt you to speak to you friendly cardiologist colleagues
Answer:
Any/all of the above
If known severe MR – these are the NEW findings that should prompt you to speak to you friendly cardiologist colleagues
3/8
Valvular Heart Dx (VHD) AHA guidelines :
Valvular Heart Dx (VHD) AHA guidelines :
4/8
So what are the standard criteria?
So what are the standard criteria?
5/8
Here is an easier algorithm from ESC 2017
Here is an easier algorithm from ESC 2017
6/8
So in PAC when should I order and echo on an Asymptomatic patient with known severe primary MR?
So in PAC when should I order and echo on an Asymptomatic patient with known severe primary MR?
7/8
What about asymptomatic Moderate MR?
If preserved LV function – echo performed every 1-2yrs a per ESC and AHA
What about asymptomatic Moderate MR?
If preserved LV function – echo performed every 1-2yrs a per ESC and AHA
8/8
To recap -
Red flags for pre op assessment of patients with known severe primary MR:
1. Symptoms
2. Impaired LV systolic function
3. Dilated LV
4. Pulmonary hypertension
5. Atrial fibrillation
To recap -
Red flags for pre op assessment of patients with known severe primary MR:
1. Symptoms
2. Impaired LV systolic function
3. Dilated LV
4. Pulmonary hypertension
5. Atrial fibrillation
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