Aortic regurgitation surgery preoperative evaluation
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For the WikiPatient page for this topic, click here; For the main page of aortic insufficiency, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Varun Kumar, M.B.B.S., Lakshmi Gopalakrishnan, M.B.B.S., Mohammed A. Sbeih, M.D.[3]
Related Key Words and Synonyms: Aortic valve replacement.
Aortic Insufficiency Preoperative Evaluation
The patient may need to have some tests before the procedure. After the diagnosis of aortic insufficiency, the general health of the patient should be assessed and the most appropriate treatment should be recommended. Some of the tests that can be done before the procedure include:
- Echocardiogram (Doppler echocardiogram).
- Cardiac catheterization.
- Chest X-ray.
- Computed tomography (CT) scan.
- Electrocardiogram (ECG).
- Electrophysiology tests.
- Exercise tests.
- Holter monitor.
- Magnetic resonance imaging (MRI).
Cardiac catheterization in patients with chronic aortic insufficiency is recommended if the noninvasive diagnostic tests are inconclusive, or if the patient is at risk of coronary heart disease and the coronary anatomy should be assessed.
Before the surgery:
- The surgeon needs to know if the patient is taking any drugs, supplements, or herbs before the procedure.
- The patient may be able to store blood in the blood bank for transfusions during and after the surgery. The family members can also donate blood (autologous donation).
- For the 2-week period before surgery, the patient should be asked to stop taking drugs that make it harder for the blood to clot. These might cause increased bleeding during the surgery. Some of these drugs are aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn).
- The day before the surgery, the patient should shower and shampoo well and wash the whole body below the neck with a special soap.
- The patient may also be asked to take an antibiotic to guard against infection.
- The patient should be informed which drugs he or she should still take on the day of the surgery.
- The patient should stop smoking.
On the day of the surgery:
- An intravenous (IV) line will be placed into a blood vessel in the patient's arm or chest to give fluids and medicines.
- The patient should be asked not to drink or eat anything after midnight the night before surgery. This includes chewing gum and using breath mints. The patient can rinse mouth with water if it feels dry without swallowing.
- Make sure that the patient is taking the drugs that he or she needs to take with a small sip of water.
- Hair near the incision site may be shaved immediately before the surgery.
- The patient should be informed when to arrive to hospital on the day of the surgery.