TY  - CHAP
M1  - Book, Section
TI  - Chapter 6. Aortic Valve Disease
A1  - Wasnick, John D.
A1  - Hillel, Zak
A1  - Kramer, David
A1  - Littwin, Sanford
A1  - Nicoara, Alina
Y1  - 2011
N1  - 
T2  - Cardiac Anesthesia and Transesophageal Echocardiography
AB  - The  aortic  valve  (AV)  is  the  gateway  through  which  the  stroke  volume  is  ejected  from  the  left  ventricle  (LV)  into  the  systemic  circulation.  When  the  AV  is  normal,  systolic  and  diastolic  pressures  are  maintained  and  the  delivery  of  oxygenated  blood  to  the  tissues  unencumbered.  Should  the  gateway  be  narrowed  as  in  aortic  stenosis  (AS),  the  LV  hypertrophies  concentrically  to  generate  increased  pressure  to  push  the  blood  through  the  reduced  aortic  valve  orifice.  The  thickened  heart  muscle  and  the  increased  work  of  ventricular  ejection  augments  the  oxygen  demand  of  the  ventricle,  which  if  not  met,  can  result  in  the  development  of  myocardial  ischemia.  On  the  other  hand,  if  the  valve  is  incompetent  resulting  in  aortic  insufficiency  or  regurgitation  (AR),  the  left  ventricle  will  dilate  and  hypertrophy  eccentrically  to  accommodate  the  increased  volume  filling  the  LV  cavity  during  diastole.  Diastolic  pressure  falls,  and  coronary  perfusion  pressure  (CPP)  decreases,  increasing  the  risk  of  ischemia.  Providing  anesthesia  for  patients  with  AV  disease  undergoing  aortic  valve  surgery  or  noncardiac  procedures  can  be  challenging.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/16
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=8550646
ER  -