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A 65 year old woman is post-op day two after aortic valve replacement for aortic stenosis. A preoperative cardiac catheterization showed a severely elevated LVEDP and she has been treated with IV diuretics. Over the course of several hours, she has progressive hypotension, and urine output decreases. An echocardiogram is obtained and the following representative M-mode image is shown. What is the appropriate next step in management?

A. IV dobutamine

B. IV furosemide and metolazone

C. Return to the OR for exploration

D. Transesophageal echocardiogram

E. IV Fluid Bolus


Valve disease

Author: Atif Qasim, MD FASE
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