Angiografia e cateterismo cardiaco valori e limiti - Cuorediverona.it

ACC/AHA task force guidelines on coronary
angiography in patients with valvular heart disease
1. Before valve surgery (including ( including infective endocarditis) endocarditis)
or mitral balloon commissurotomy in patients with: with I
Chest pain
Other objective evidence of ischemia
Decreased LV systolic function
History of CAD
Coronary risk factors (including ( including advanced age) age
2. Patients with apparently mild to moderate valvular heart disease but with: with:
I
Progressive (class II or greater) greater)
angina
Objective evidence of ischemia
Decreased LV systolic function
Overt congestive heart failure
3. Patients undergoing catheterization to confirm the severity of valve lesions before valve surgery without preexisting
evidence of CAD, multiple coronary risk factors, factors,
or advanced age IIb
4. Young patients undergoing nonemergent valve surgery when no further hemodynamic assessment by catheterization
is deemed necessary and no coronary risk factors, factors,
no history of CAD, and no evidence of ischemia are present III
5. Asymptomatic patients with valvular heart disease when valve surgery or balloon commissurotomy is not being
considered III
6. Patients having emergency valve surgery for acute valve regurgitation, regurgitation aortic root disease, disease,
or infective endocarditis when
there are no coronary risk factors, factors,
angina, objective evidence of ischemia, ischemia evidence of coronary embolization, embolization,
LV
systolic dysfunction, dysfunction,
or age