What are the specific postoperative considerations for the patient with aortic stenosis?

Location & Review
  • HDU / ICU for ongoing BP monitoring:
    • NCEPOD recommends admission for valve area <1cm2
    • Should be strongly considered if reduced systolic function
 
Monitoring & Investigations
  • Monitor for renal dysfunction
 
Analgesia
  • Avoid NSAIDS – high risk of renal dysfunction
  • Ensure optimum analgesia to avoid tachycardia
  • Regional anaesthesia may be beneficial
 
Supportive Care
  • Continue haemodynamic aims
  • May require vasopressor infusions and ongoing invasive arterial BP monitoring to maintain haemodynamic stability
  • Ensure meticulous attention to appropriate intravascular filling