Assessing and Reducing the Cardiac Risk of Noncardiac Surgery

Abstract

A ccurate estimation of a patient's risk for postoperative cardiac events (eg, myocardial infarction, unstable angina, ventricular tachycardia, pulmonary edema, and death) after noncardiac surgery can guide allocation of clinical resources, use of preventive therapies, and priorities for future research. This review addresses selected issues in clinical risk assessment, approaches to using diagnostic tests, choices among preventive interventions, and postoperative monitoring. Although we have not used a formal systematic

Use Of Beta-Blockers During Aortic Aneurysm Repair: Bridging The Gap Between Evidence And Effective Practice

“…The Revised Cardiac Risk Index (RCRI) score is the most widely used risk-assessment model and is strongly correlated with the potential benefit achieved through use of perioperative beta-blockers. 15 This is supported by a recent large observational study that evaluated more than 122,000 surgical patients treated with perioperative beta-blockers, showing an incremental mortality benefit associated with these agents in patients with two or more RCRI criteria. 16 Second, the risk of cardiac morbidity and mortality associated with specific types of operations must be taken into consideration.…”

Cardioneurology: The Up-to-Date Key Positions and the Future Prospects

“…В насто-ящее время изучены частота и виды кардиальных и церебральных осложнений при открытых и эндоваску-лярных операциях на брахиоцефальных артериях [56,57]. Показано, что в раннем послеоперационном периоде (30 дней) каротидная эндартерэктомия чаще осложняется инфарктом миокарда, а баллонная ангиопластика со стен-тированием -церебральными расстройствами (инсульт, ТИА, асимптомное церебральное поражение) [58].…”

II Diretriz de Avaliação Perioperatória da Sociedade Brasileira de Cardiologia

“…When valvular heart disease is suspected after clinical history and physical examination, the complementary method of choice is Doppler echocardiography 76 . In case of persistent diagnostic uncertainty, other methods are possible, such as contrast ventriculography, MRI, and catheterization 77 .…”