Noncardiac surgery in the patient with heart disease

Anesthesiology Clinics
James B Froehlich, Lee A Fleisher

Abstract

Clinicians are increasingly asked what they can do to evaluate and lower the risk of perioperative cardiac complications. Approximately 4 decades ago, there were few tools to guide the evaluation of perioperative risk. The American Society of Anesthesiology Classification System (ASA class) gave only a vague idea of the risk patients faced during surgery, but the modern era of clinical risk assessment for perioperative complications has seen the introduction of tools that allow clinicians to estimate risk, and also the addition of stress testing for assessing perioperative risk. None of these tests, however, were designed to identify perioperative cardiac risk. This article reviews the literature on perioperative risk assessment, risk reduction, and testing modalities in patients with cardiac disease, along with the role of perioperative angioplasty and the current American College of Cardiology/American Heart Association guidelines.

References

Oct 20, 1977·The New England Journal of Medicine·L GoldmanE E Slater
Apr 28, 2004·Journal of Vascular Surgery·Anai E S DurazzoBruno Caramelli
Dec 31, 2004·The New England Journal of Medicine·Edward O McFallsWilliam G Henderson
Jul 29, 2005·The New England Journal of Medicine·Peter K LindenauerEvan M Benjamin
Sep 24, 2005·Stroke; a Journal of Cerebral Circulation·James KennedyThomas E Feasby
Sep 5, 2006·Journal of the American College of Cardiology·Don PoldermansUNKNOWN Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echo Study Group

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Citations

Mar 31, 2011·Langenbeck's Archives of Surgery·Marian GradeB Michael Ghadimi
Aug 13, 2010·Journal of Cardiothoracic and Vascular Anesthesia·Nina SinghJohn G T Augoustides

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