RT Book, Section A1 Wasnick, John D. A1 Hillel, Zak A1 Kramer, David A1 Littwin, Sanford A1 Nicoara, Alina SR Print(0) ID 8550646 T1 Chapter 6. Aortic Valve Disease T2 Cardiac Anesthesia and Transesophageal Echocardiography YR 2011 FD 2011 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-171798-4 LK accessanesthesiology.mhmedical.com/content.aspx?aid=8550646 RD 2024/03/28 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.