Cardiac assessment prior to non-cardiac surgery

Mooney, John; Hillis, Graham S.; Lee, V.; Khan, Eesha; Halliwell, Richard; Vicaretti, Mauro; Moncrieff, Colin; Chow, Clara K

doi:10.1016/j.hlc.2015.06.616

Cited by 1 publication

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“…Guidelines recommend that patients who are undergoing an elective operation should be screened for active cardiac disease and appropriately managed prior to surgery . Assessing cardiac disease in stable, asymptomatic patients prior to their non‐cardiac surgeries is valuable, and despite lack of concordance to support the use of TTE as part of routine preoperative cardiac evaluation, it is becoming increasingly popular in clinical practice due to its utility in detecting cardiac disease through non‐invasive means . Preoperative ECGs are of no benefit for patients without any cardiac risk factors who are undergoing low‐risk surgeries.…”

Section: Discussionmentioning

confidence: 99%

Preoperative cardiac and respiratory investigations do not predict cardio‐respiratory complications after pancreatectomy

Ashrafizadeh

Mehta

Nahm

et al. 2019

ANZ Journal of Surgery

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Background The process of undergoing a pancreatic resection places a patient under notable physiologic strain throughout the perioperative journey, with well recognized risks of postoperative cardiopulmonary complications. Preoperative preparations and screening often incorporate a barrage of testing, including electrocardiograms, transthoracic echocardiography, chest X‐rays and spirometric evaluations. However, the current literature does not demonstrate whether these common tests provide any predictive correlation with postoperative cardiopulmonary complications. This retrospective study is structured to identify complications in post‐pancreatic resection patients and assess for a predictive correlation with preoperative test results. Methods A retrospective analysis of all patients having undergone a pancreatic resection at a single tertiary centre, between 2014 and 2016. The inpatient medical records were reviewed for 30‐day postoperative complications, including acute myocardial infarction, cardiac dysrhythmia, pulmonary embolism, pneumonia or pleural effusions. The results of routine preoperative diagnostic tests and complication rates were analysed. Results A total of 244 patients, median age of 66 years (range 18–88 years) were included in the study. Of these, 11 patients experienced a cardiac complication and 16 patients experienced a respiratory complication. Among those who experienced cardiac events, only two patients had abnormalities in their preoperative electrocardiograms. Patients who sustained a cardiac or respiratory event did not have any evidence of abnormality in their preoperative transthoracic echocardiography or respiratory investigations, respectively. Conclusion Despite the recommendation that high‐risk procedures such as pancreatic resections warrant thorough, routine, preoperative cardiac and respiratory investigation, a more functional preoperative assessment should be considered to stratify and predict postoperative outcomes.

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Section: Discussionmentioning

confidence: 99%