Preoperative evaluation of patients with, or at risk of, coronary artery disease undergoing non-cardiac surgery
Details
Serval ID
serval:BIB_F2117258654A
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Preoperative evaluation of patients with, or at risk of, coronary artery disease undergoing non-cardiac surgery
Journal
British Journal of Anaesthesia
ISSN
0007-0912 (Print)
Publication state
Published
Issued date
11/2002
Volume
89
Number
5
Pages
747-59
Notes
Journal Article
Review --- Old month value: Nov
Review --- Old month value: Nov
Abstract
The increasing number of patients with coronary artery disease undergoing major non-cardiac surgery justifies guidelines concerning preoperative evaluation, stress testing, coronary angiography, and revascularization. A review of the recent literature shows that stress testing should be limited to patients with suspicion of a myocardium at risk of ischaemia, and coronary angiography to situations where revascularization can improve long-term survival. Recent data have shown that any event in the coronary circulation, be it new ischaemia, infarction, or revascularization, induces a high-risk period of 6 weeks, and an intermediate-risk period of 3 months. A 3-month minimum delay is therefore indicated before performing non-cardiac surgery after myocardial infarction or revascularization. However, this delay may be too long if an urgent surgical procedure is requested, as for instance with rapidly spreading tumours, impending aneurysm rupture, infections requiring drainage, or bone fractures. It is then appropriate to use perioperative beta-block, which reduces the cardiac complication rate in patients with, or at risk of, coronary artery disease. The objective of this review is to offer a comprehensive algorithm to help clinicians in the preoperative assessment of patients undergoing non-cardiac surgery.
Keywords
Adrenergic beta-Antagonists/adverse effects
Aged
*Algorithms
Coronary Disease/*complications
Diabetes Complications
Echocardiography, Stress
Electrocardiography/methods
Humans
Male
Myocardial Infarction/complications
Myocardial Ischemia/complications
Myocardial Revascularization/adverse effects
Predictive Value of Tests
Preoperative Care/*methods
Risk Assessment
Risk Factors
Surgical Procedures, Operative
Vascular Surgical Procedures/adverse effects
Pubmed
Web of science
Open Access
Yes
Create date
28/01/2008 9:47
Last modification date
20/08/2019 16:19