Sandbox:AHAPrince

2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery

Class I
"1. It is recommended that patients with clinically suspected moderate or greater degrees of valvular stenosis or regurgitation undergo preoperative echocardiography if there has been either 1) no prior echocardiography within 1 year or 2) a significant change in clinical status or physical examination since last evaluation(Level of Evidence: C)"
"2. . For adults who meet standard indications for valvular intervention (replacement and repair) on the basis of symptoms and severity of stenosis or regurgitation, valvular intervention before elective noncardiac surgery is effective in reducing perioperative risk(Level of Evidence: C)"

Class IIa
"1. Elevated-risk elective noncardiac surgery with appropriate intraoperative and postoperative hemodynamic monitoring is reasonable to perform in patients with asymptomatic severe aortic stenosis (Level of Evidence: B)"
"2. . Elevated-risk elective noncardiac surgery with appropriate intraoperative and postoperative hemodynamic monitoring is reasonable in adults with asymptomatic severe MR (Level of Evidence: C)"
"3. Elevated-risk elective noncardiac surgery with appropriate intraoperative and postoperative hemodynamic monitoring is reasonable in adults with asymptomatic severe aortic regurgitation and a normal left ventricular ejection fraction (Level of Evidence: C)"

Class IIb
"1. . Elevated-risk elective noncardiac surgery using appropriate intraoperative and postoperative hemodynamic monitoring may be reasonable in asymptomatic patients with severe mitral stenosis if valve morphology is not favorable for percutaneous mitral balloon commissurotomy. (Level of Evidence: C)"

Class III (Harm)
"1. RECOMMENDATION 1 HERE (Level of Evidence: C)"
"2. RECOMMENDATION 2 HERE (Level of Evidence: C)"

Class III (No Benefit)
"1. RECOMMENDATION 1 HERE (Level of Evidence: C)"
"2. RECOMMENDATION 2 HERE (Level of Evidence: C)"