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notescardiacvalvular ( ** )

Cardiac valvular lesions

* For stenotic valvular lesions:
– “slow and SVR and sinus”
– maintain sinus rhythm
– keep the rate slow to allow chambers to empty
– keep the systemic vascular resistance (SVR) up as the organ perfusion is dependent upon it
– avoid spinal or epidural anesthesia as these will drop the SVR
* For regurgitant lesions:
– “fast and full and forward”
– a faster rate diminishes regurgitant time
– adequate volume discourages regurgitant flow
– a slightly diminished SVR encourages forward flow

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