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Erschienen in:
15.02.2022 | Surgical Care (F Luchette, Section Editor)
Optimizing Cardiac Performance During the Perioperative Period
Erschienen in: Current Geriatrics Reports | Ausgabe 4/2021
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Purpose of Review
Perioperative adverse cardiac events commonly affect patients undergoing surgery and are even increasingly more common as patients age. The purpose of this paper is to review recent literature and society guidelines regarding screening and optimizing these patients in the perioperative period.
Recent Findings
There remains a relative paucity of prospective, randomized control trials regarding cardiac optimization/risk-reduction in patients undergoing noncardiac surgery. Current guidelines are focused primarily on identifying patients at an increased risk of perioperative cardiac adverse events, performing appropriate preoperative work-up, and weighing the risk of cardiac event—with or without preoperative optimization with medications and/or revascularization—against the potential consequences of abstaining from surgery.
Summary
Numerous risk factors have been identified which increase patients’ risk for perioperative adverse cardiac events such as pre-existing ischemic heart disease or heart failure, advanced age, medical comorbidities, and type of surgery being performed. While cardiac risk stratification for surgery is well-established, the optimization of these patients remains somewhat ambiguous. Further prospective research is needed to address preoperative medical optimization, intraoperative management, and postoperative monitoring and management to reduce these risks.