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The aging population and an epidemic of heart failure have led to an increasing volume of noncardiac surgical procedures being performed in patients with heart failure. Knowledge pertaining to perioperative risk stratification and management among this diverse and complex cohort of patients has therefore become increasingly important. Most available data regarding the management of patients with heart disease undergoing noncardiac surgery is specific to patients with ischemic heart disease, and focuses on the prevention of ischemia and its subsequent complications. This review instead specifically explores the available data regarding the epidemiology and outcomes of the surgical patient with heart failure, with a focus on risk stratification and perioperative management.
Division of Cardiology, Tufts University School of Medicine, Tufts Medical Center, Box 244, South Building, 800 Washington St., Boston, MA, 02111, USA, firstname.lastname@example.org.
This article was published in the following journal.
Name: Current heart failure reports
When patients present to the emergency department with a complaint concerning for heart disease, this often becomes the primary focus of their evaluation. While patients with noncardiac causes of ches...
Acute myocardial infarction (AMI) is one of the most important perioperative complications of total knee arthroplasty (TKA). Although risk-stratification tools exist for the prediction of cardiac comp...
Based on 2 small randomized controlled trials (RCTs) from the 1990s, β-blockers were promoted to prevent perioperative cardiac events in patients undergoing noncardiac surgery. In 2008, a large RCT (...
Each year, cardiac complications occur within 30 days after major noncardiac surgery in more than 10 million people worldwide; postoperative mortality is 1.5%. Enhanced patient monitoring and measurem...
Postoperative pain continues to be undertreated after noncardiac surgery. Preoperative analgesic administration may enhance postoperative analgesia.
This prospective study intends to investigate the incidence of postoperative pulmonary complications (PPC) or in-hospital mortality in patients with COPD or at risk for COPD undergoing hig...
Over time there is a need to improve old and develop new risk models. The assessment of mortality risk in cardiac surgery is performed with the use of preoperative risk models. The use of ...
Non-cardiac surgery is associated with significant cardiac morbidity and mortality. Volatile anesthetics have a cardioprotective effects which results in preservation of left ventricular f...
Postoperative delirium is an important problem in patients undergoing major cardiac surgery and associated with more complicated hospital course, increased hospital length of stay and tota...
Major adverse cardiovascular events (MACE) are a leading cause of serious complications and death following major noncardiac surgery. The heart biomarkers brain-type natriuretic peptide (B...
A short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. It is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. The short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. It is water-soluble at pH less than 4 and lipid-soluble at physiological pH.
Surgery which could be postponed or not done at all without danger to the patient. Elective surgery includes procedures to correct non-life-threatening medical problems as well as to alleviate conditions causing psychological stress or other potential risk to patients, e.g., cosmetic or contraceptive surgery.
A synthetic nondepolarizing blocking drug. The actions of gallamine triethiodide are similar to those of TUBOCURARINE, but this agent blocks the cardiac vagus and may cause sinus tachycardia and, occasionally, hypertension and increased cardiac output. It should be used cautiously in patients at risk from increased heart rate but may be preferred for patients with bradycardia. (From AMA Drug Evaluations Annual, 1992, p198)
Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed)
Devices which mechanically oxygenate venous blood extracorporeally. They are used in combination with one or more pumps for maintaining circulation during open heart surgery and for assisting the circulation in patients seriously ill with some cardiac and pulmonary disorders. (UMDNS, 1999)
An anesthesiologist (US English) or anaesthetist (British English) is a physician trained in anesthesia and perioperative medicine. Anesthesiologists are physicians who provide medical care to patients in a wide variety of (usually acute) situations. ...