Preoperative evaluation of patients with, or at risk of, coronary artery disease undergoing non-cardiac surgery

Détails

ID Serval
serval:BIB_F2117258654A
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Preoperative evaluation of patients with, or at risk of, coronary artery disease undergoing non-cardiac surgery
Périodique
British Journal of Anaesthesia
Auteur(s)
Chassot  P. G., Delabays  A., Spahn  D. R.
ISSN
0007-0912 (Print)
Statut éditorial
Publié
Date de publication
11/2002
Volume
89
Numéro
5
Pages
747-59
Notes
Journal Article
Review --- Old month value: Nov
Résumé
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.
Mots-clé
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
Oui
Création de la notice
28/01/2008 10:47
Dernière modification de la notice
09/05/2019 3:21
Données d'usage