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ALD n° 5 - Cardiopathies valvulaires et congénitales graves chez l’adulte - ALD n° 5 - Severe valvular and congenital heart diseases in adults

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Posted on Jul 21 2008 The aim of this guide for medical practitioners is to describe the optimal theorical care and the clinical pathway for a patient entering the ALD [Long term condition] scheme, severe valvular heart disease. The aim of this guide for medical practitioners is to describe the optimal theorical care and the clinical pathway for a patient entering the ALD [Long term condition] scheme, severe valvular heart disease. Posted on Jul 21 2008

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Published 01 June 2008
Reads 20
Language English
 
 
 
             
LONG-TERM CONDITIONS GUIDE
Severe valvular and congenital heart diseases in adults
     
June 2008
 
              
 
This doctors’ guide is available for download at www.has-sante.fr
 Haute Autorité de Santé Communication Department  2, avenue du Stade-de-France – F 93218 Saint-DenisLa Plaine Cedex Phone: +33 (0)1 55 93 70 00 - Fax: +33 (0)1 55 93 74 00  
            This document was validated by the HAS Board in June 2008. © Haute Autorité de Santé – 2008
 
 
ALD Guide for doctors – Severe valvular and congential heart diseases in adults  
Contents
List of abbreviations ...........................................................................3 
Introduction
1. 1.1 1.2 1.3 1.4 1.5 1.6 1.7 
2. 2.1 2.2 2.3 2.4 2.5 2.6 2.7 
...............................................................................6 
Initial assessment .....................................................................8 
Objectives ............................................................................ 8 Professionals involved ........................................................ 8 Diagnosis ............................................................................. 8 Complementary tests ........................................................ 10 Risk of infectious endocarditis assessment...................... 11 Thromboembolic risk assessment .................................... 11 Specific case of pregnant women or women wishing to become pregnant .............................................................. 12 
Therapeutic management .......................................................13 
Objectives .......................................................................... 13 Professionals involved ...................................................... 13 Self management education ............................................. 14 Pharmacological treatments ............................................. 15 Invasive treatment ............................................................. 18 Procedure in the event of non-cardiac surgery ................ 20 Implantable medical devices............................................. 21 
3. Follow-up .............................................................................23 3.1 Objectives .......................................................................... 23 3.2 Professionals involved ...................................................... 23 3.3 Clinical monitoring ............................................................. 25 3.4 Additional tests .................................................................. 25 
Appendix 1. Participants .................................................................27 
Appendix 2. Target INR in the case of a mechanical prosthesis ......28 
Appendix 3. Self-measurement and self-monitoring in the case of VKA treatment ........................................................................29  
HAS / Department of Chronic Diseases and Patient Support June 2008
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ALD Guide for doctors – Severe valvular and congential heart diseases in adults  
Appendix 4. Management of valvular heart conditions ....................30 
Appendix 5. Management of complex congenital heart conditions ..38 
Appendix 6 Indications for coronary angiography ...........................40 
Appendix 7. References ..................................................................41      
      
 
 Updating of doctors’ guides and lists for long-term conditions  The long-term conditions guides produced by HAS are revised every three years.
This document may be downloaded from www.has-sante.fr  
HAS / Department of Chronic Diseases and Patient Support June 2008 -2-