Aortic valvular disease: Pathophysiology and anaesthetic management for general surgical procedures

Over the past four years 157 patients with aortic valvular disease have been anaesthetized at the Vancouver General Hospital for a variety of 224 surgical procedures, other than for definitive pump-oxygenator open-heart surgery. Patients presenting with this disease are therefore not uncommon and the number has shown a steady progressive increase each year. Two categories of surgery are usually involved: (1) general, elective or emergency, (2) diagnostic, left ventricular and femoral artery puncture, left atrial puncture, and cardiac catheterization. It is anticipated that there will be an increase in the number of diagnostic procedures requiring anaesthesia as more successful definitive corrective surgery is made available.