瓣膜病的手术时机选择.pptVIP

Indications for Aortic Valve Replacement in pts with AS Class I AVR is indicated for symptomatic patients with severe AS (LOE: B) AVR is indicated for patients with severe AS undergoing CABG (LOE: C) AVR is indicated for patients with severe AS undergoing surgery on the aorta or other heart valves. (LOE: C) AVR is recommended for patients with severe AS and LV systolic dysfunction (EF ? 0.50). (LOE: C) Class IIa AVR is reasonable for pts with moderate AS undergoing CABG or surgery on the aorta or other heart valves (LOE: B) Indications for Aortic Valve Replacement in pts with AS Class IIb AVR may be considered for asymptomatic pts with severe AS and abnormal response to exercise (e.g., development of symptoms or asymptomatic hypotension). (LOE: C) AVR may be considered for adults with severe asymptomatic AS if there is a high likelihood of rapid progression (age, calcification, and CAD) or if surgery might be delayed at the time of symptom onset. (LOE: C) Indications for Aortic Valve Replacement in pts with AS Class IIb AVR may be considered in pts undergoing CABG who have mild AS when there is evidence, such as moderate to severe valve calcification, that progression may be rapid. (LOE: C) AVR may be considered for asymptomatic pts with extremely severe AS (AVA? 0.6 cm2 , MPG? 60 mm Hg, and jet velocity ? 5.0m/sec) when the patient’s expected operative mortality is ?1.0% (LOE: C) Indications for Aortic Valve Replacement in pts with AS Class III AVR is not useful for the prevention of sudden death in asymptomatic patients with AS who have none of the findings listed under the class IIa/IIb recommendations. (LOE: B) Indications for Aortic Valve Replacement in pts with AR Class I AVR is indicated for symptomatic pts with severe AR irrespective of LV systolic function. (LOE: B) AVR is indicated for asymptomatic pts with chronic severe AR and LV systolic dysfunction (EF? 0.50) at rest. (LOE:B) AVR is indicated for pts with chronic severe AR while undergoi