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Continuing Education in Anaesthesia, Critical Care & Pain 2005 5(1):1-4; doi:10.1093/bjaceaccp/mki001
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Continuing Education in Anaesthesia, Critical Care & Pain | Volume 5 Number 1 2005 © The Board of Management and Trustees of the British Journal of Anaesthesia 2005

Aortic stenosis and non-cardiac surgery

Jane Brown, MBBS FANZCA, Fellow in Cardiothoracic Anaesthesia
Northern General Hospital, Herries Road, Sheffield, S5 7AU

Nicholas J Morgan-Hughes, MBChB MRCP FRCA, Consultant Anaesthetist
Northern General Hospital, Herries Road, Sheffield, S5 7AU
Tel: 0114 2714818, Fax: 0114 2269342, E-mail: n.hughes{at}sheffield.ac.uk (for correspondence)

Goldman and colleagues identified severe aortic stenosis as a risk factor for perioperative cardiac complications in non-cardiac surgery in 1977.1 Furthermore, they emphasized that this risk was significantly increased by the presence of coexisting cardiac failure and dysrhythmias. The National Confidential Enquiry into Perioperative Deaths has expressed concerns in several recent reports about the assessment and management of patients with aortic stenosis who undergo surgery. In the UK, aortic stenosis is most often a degenerative disease that is increasing in incidence as people live longer; it occurs frequently in patients with significant comorbidities. The condition is often unrecognized before death and post-mortem data suggest an end of life incidence of 1%. Aortic stenosis may also be present at birth; congenital malformation registry data suggest a live birth incidence of ~0.1%.


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