Prognostic and management role of cardiovascular ultrasound in surgically treated aortic stenosis. A picture (with pressure) is worth a thousand inotropic agents.

Abstract

Cardiovascular ultrasound in the postoperative setting can be of value in helping to manage the patient who has undergone aortic valve replacement and is having a stormy postoperative course. Preoperative echocardiograms may not only detect the presence of those characteristics most likely to cause such a postoperative course but also select early postoperative pharmaceutical and volume interventions that are appropriate. It is hoped that the ability to preoperatively recognize those patients who are at high risk for developing intracavitary gradients will aid in appropriately managing them postoperatively and preventing the effects of prolonged hypotension secondary to intracavitary gradients. In addition, the early use of cardiovascular ultrasound in the postoperative patient to determine the functional and hemodynamic status of the ventricle, valvular structures, and pericardium may lead to appropriate early intervention, be it pharmacological or surgical, in patients who are having a complicated postoperative course.