Mahmoud ABU-ABEELEH Mahmoud ABU-ABEELEH Associate Professor Associate Professor Department of Surgery Department of Surgery Division of Cardiothoracic Surgery Division of Cardiothoracic Surgery School of Medicine School of Medicine University Of Jordan University Of Jordan Adult Cardiac Adult Cardiac Surgery Surgery
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Mahmoud ABU-ABEELEH Associate Professor Department of Surgery Division of Cardiothoracic Surgery School of Medicine University Of Jordan Adult Cardiac.
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Mahmoud ABU-ABEELEHMahmoud ABU-ABEELEHAssociate ProfessorAssociate Professor
Department of SurgeryDepartment of SurgeryDivision of Cardiothoracic SurgeryDivision of Cardiothoracic Surgery
School of Medicine School of MedicineUniversity Of JordanUniversity Of Jordan
Coronary heart disease: (CABG)Triple vessel diseaseLf main coronary artery diseaseUnstable angina ,failed Mx therapyComplications of PTCALife threatening complications of MI
rheumatic disease, bicuspid valve, aortic dissection, Marfan, etc. Indications for surgery
Acute AR- inadequate time for ventricular compensation Chronic AR- symptoms, decreasing EF, LVEDD >75mm, LVESD >55mm
Pathophysiolgy of AS
Except in the congenital forms, AS develops slowly
The LV becomes increasingly hypertrophied, and coronary blood flow may become inadequate
The fixed outflow obstruction limits the increase in C.O required on exercise.
The progressive LV outflow obstruction results in increased LV mass. This increase in wall thickness is a compensatory mechanism to normalize LV wall stress
Symptoms of AS
Exertional dyspnea Angina Pulmonary edema Exertional syncope Sudden death
Aortic position Bileaflet- INR of 2-3 Other disk valves and Starr-Edwards- INR 2.5-3.5 In patients with higher risk of TE, INR 2.5-3.5 with addition of aspirin