Post-AVR Vasoplegia Management

Initial Management and Monitoring

The American College of Cardiology recommends providing adequate fluid resuscitation while closely monitoring volume status to prevent both hypovolemia and fluid overload 1
The American College of Cardiology suggests maintaining adequate hydration and avoiding early aggressive diuretic administration to minimize acute kidney injury risk 1
Continuous monitoring of vital signs, including telemetry, blood pressure, heart rate, and oxygen saturation, is crucial 1
Meticulous monitoring of the access site for bleeding, hematoma, or pseudoaneurysm formation is essential 2, 1
Strict intake and output monitoring is necessary to guide fluid management 1

The American College of Cardiology recommends restarting appropriate preoperative medications promptly, reviewing ACE inhibitors carefully given their association with vasoplegia 2, 1
The American College of Cardiology suggests initiating aspirin 75-100 mg daily lifelong and clopidogrel 75 mg daily for 3-6 months per standard post-AVR protocols 3, 1
Obtaining a predischarge echocardiogram to establish baseline valve function is recommended 3, 1
Promoting early mobilization as soon as hemodynamically stable to prevent deconditioning is crucial 2, 1