Perioperative Management of the Patient With Cardiac Disease

Decker, Robert C.; Foley, Joseph M.; Moore, Thomas J.

doi:10.5435/00124635-201005000-00003

Cited by 9 publications

(3 citation statements)

References 60 publications

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“…Given the signifi cantly higher incidence of bleeding complications and insignifi cant difference in the incidence of ischaemic complications in patients after THA or TKA compared to patients after other orthopaedic procedures, we can ask whether consistent perioperative anticoagulation prophylaxis in patients with arthroplasty may be the reason for the reduced incidence of ischaemic complications or the cause of increased incidence of bleeding complications (4,5,7,12,15,16). We cannot answer this speculative question based on the results achieved in our study.…”

Section: Discussionmentioning

confidence: 38%

THA and TKA in patients with cardiovascular disease: What makes the risk of perioperative bleeding?

Džupa¹,

Motovska²,

Widimský³

et al. 2017

BLL

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BACKROUND: The purpose of the study was to ascertain the incidence of bleeding and ischaemic complications in patients with cardiac disease after total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: In total, 477 patients (289 women, 188 men) with known history of cardiac disease or thromboembolic disease treated with surgery in 2010-2013, were enrolled in the study. Perioperative prevention of thromboembolic disease using low-molecular-weight heparins was applied in all the patients. The data that could have an impact on the development of monitored perioperative complications, were observed. RESULTS: Complications occurred in 55 (11.6 %) patients: bleeding complications in 32, ischaemic in 19, and both in four patients. Complications were found in 13 (12.0 %) patients after THA and in 6 (9.5 %) patients after TKA. Bleeding complications were observed in 17 patients after THA and TKA, ischaemic in one, and both simultaneously in one patient. Bleeding complications occurred insignifi cantly more frequently after THA and TKA (p = 0.094); however, this difference was statistically signifi cant after adjustment for risk factors (p = 0.003). On the contrary, ischaemic complications were signifi cantly more frequent after other skeletal surgeries (p = 0.014). Nevertheless, this difference was not statistically signifi cant after the adjustment (p = 0.880). The comparison of the risk of complications in patients after THA with that in patients after TKA showed no signifi cant difference (p = 0.580). CONCLUSION: The study showed a signifi cantly higher incidence of bleeding complications in patients after THA and TKA compared to other surgeries of the musculoskeletal system in patients with a history of cardiac disease. Bleeding complications cannot be detected in advance (Tab. 1, Ref. 16). Text in PDF www.elis.sk.

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Section: Discussionmentioning

confidence: 38%

THA and TKA in patients with cardiovascular disease: What makes the risk of perioperative bleeding?

Džupa¹,

Motovska²,

Widimský³

et al. 2017

BLL

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“…Patients unable to perform four METs daily have increased risks of postoperative heart and organ diseases. Patients unable to climb stairs, climb hills, walk at 4 miles per hour on flat surfaces, or do heavy house chores may have high risks of cardiac complications before and after surgery; thus, preoperative examination and preparation are crucial [ 7 , 9 , 10 ] ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…The 2014 American College of Cardiology (ACC)/American Heart Association (AHA) and European Society of Cardiology (ESC)/European Society of Anesthesiology (ESA) guidelines summarized the perioperative evaluation and management methodologies for patients undergoing noncardiac surgery. Several articles have also outlined the management of patients undergoing noncardiac surgery, including orthopedic surgery, among patients with underlying IHD [ 9 , 10 ]. However, no studies have provided the specific management of patients with IHD requiring spine surgery.…”

Section: Introductionmentioning

confidence: 99%

Management of Patients with Ischemic Heart Disease in Spine Surgery

Song,

Kim,

Song

et al. 2023

Asian Spine J

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In ischemic heart disease (IHD), the myocardium does not receive enough blood and oxygen. Although the IHD-related mortality rate is decreasing, the risk remains and is a major predictor of cardiac complications following noncardiac surgery. Given the increase in the older population, the number of patients with spinal diseases requiring surgery is increasing. Among these patients, those with underlying IHD or a high risk of cardiac complications before and after surgery are also increasing. Given that cardiac complications following spinal surgery are associated with delayed patient recovery and even death, spinal surgeons should be knowledgeable about overall patient management, including medication therapy in those at high risk of developing perioperative cardiac complications for successful patient care. Before surgery, the underlying medical conditions of patients should be evaluated. Patients with a history of myocardial infarction should be checked for a history of surgical treatments, and the anticoagulant dose should be controlled depending on the surgery type. In addition, the functional status of patients must be examined before surgery. Functional status can be assessed according to the metabolic equivalent of task (MET). More preoperative cardiac examinations are needed for patients who are unable to perform four METs in daily because of the high risk of postoperative cardiac complications. Patients with a history of IHD require appropriate preoperative management and further postoperative evaluation. When considering surgery, spinal surgeons should be knowledgeable about patient care before and after surgery.

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Special Anesthetic Considerations for Endourology: Ureteroscopy and Percutaneous Nephrolithotomy

Bodin

Edwards

2012

Smith's Textbook of Endourology

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Perioperative Management of the Patient With Cardiac Disease

Cited by 9 publications

References 60 publications

THA and TKA in patients with cardiovascular disease: What makes the risk of perioperative bleeding?

THA and TKA in patients with cardiovascular disease: What makes the risk of perioperative bleeding?

Management of Patients with Ischemic Heart Disease in Spine Surgery

Special Anesthetic Considerations for Endourology: Ureteroscopy and Percutaneous Nephrolithotomy

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