Guidelines for Perioperative Cardiovascular Evaluation and Management for Noncardiac Surgery (JCS 2014)　― Digest Version ―

Kyo, Shunei; Imanaka, Kazuhito; Masuda, Mitsuharu; Miyata, Tetsuro; Morita, Kiyozo; Morota, Tetsuro; Nomura, Masatoshi; Saiki, Yoshikatsu; Sawa, Yoshiki; Sueda, Taijiro; Ueda, Yuichi; Yamazaki, Kenji; Yozu, Ryohei; Iwamoto, Mari; Kawamoto, Shunsuke; Koyama, Isamu; Kudo, M.; Matsumiya, Goro; Orihashi, Kazumasa; Oshima, Hideki; Saitô, Satoshi; Sakamoto, Yoshimasa; Shigematsu, Kunihiro; Taketani, Tsuyoshi; Komuro, Issei; Takamoto, Shinichi; Tei, Chuwa; Yamamoto, Fujio

doi:10.1253/circj.cj-66-0135

Cited by 23 publications

(18 citation statements)

References 111 publications

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“…In Japan, in 2009, the JCS released guidelines for the management of AC and AP therapies in cardiovascular disease. Subsequently, in 2014, the JCS released guidelines for preoperative cardiovascular evaluation and management for non-cardiac surgery (JCS 2014) [18] . In 2012, the American College of Chest Physicians released guidelines for the perioperative management of antithrombotic therapy (ACCP 2012) [19] .…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic and Thromboembolic Complications after Hepato-Biliary-Pancreatic Surgery in Patients Receiving Antithrombotic Therapy

Ishida¹,

Fukumoto²,

Kido³

et al. 2016

Dig Surg

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Background: Perioperative management for patients receiving long-term anticoagulant (AC) and antiplatelet (AP) therapy is a great concern for surgeons. This single-center retrospective study evaluated the risks of hemorrhage and thromboembolism after hepato-biliary-pancreatic (HBP) surgery in such patients. Methods: Between 2009 and 2014, 886 patients underwent HBP surgery. Patients were categorized into the AC (n = 39), AP (n = 77), or control (n = 770) group according to the administration of antithrombotic drugs. Perioperative management of AC and AP therapies followed the guidelines of the Japanese Circulation Society. The incidences of hemorrhage and thromboembolism were compared among groups. We used 1:1 propensity score matching and compared the incidences between the matched pairs. Results: There were 0, 1 (1.3%), and 26 (3.4%) hemorrhagic complications in the AC, AP, and control groups, respectively (p = 0.16). There were 0, 1 (1.3%), and 6 (0.8%) thromboembolic complications in the AC, AP, and control groups, respectively (p = 0.66). There was no significant difference in hemorrhagic and thromboembolic complications between the propensity-matched pairs. Conclusion: The incidences of hemorrhage and thromboembolism after HBP surgery in patients receiving long-term AC and AP therapies are within acceptable ranges.

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Section: Discussionmentioning

confidence: 99%

Hemorrhagic and Thromboembolic Complications after Hepato-Biliary-Pancreatic Surgery in Patients Receiving Antithrombotic Therapy

Ishida¹,

Fukumoto²,

Kido³

et al. 2016

Dig Surg

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“…Guidelines suggest the RCRI as the tool of choice to evaluate the cardiovascular risk: patients with RCRI ≤ 2 are at low or medium risk and should be referred only for appropriate therapy (beta‐blockers and statins) without further cardiological evaluations; patients with RCRI > 2 are considered as high‐risk patients and should undergo further noninvasive tests. Guidelines suggest coronary angiography only after positive noninvasive testing whereas coronary revascularization is not recommended to reduce cardiac events in patients with significant CAD (Class III, Level of Evidence B) 17 …”

Section: Discussiоnmentioning

confidence: 99%

“…Our results evidence that patients with severe CAD treated by preventive PCI displayed similar results compared with patients without CAD or with mid/moderate coronary lesions. Compared with results from the largest reviews on this topic, our strategy of preventive treatment of severe CAD and less invasive approach for aneurysm repair, allowed a threefold hospital and 12‐month reduction of cumulative cardiac events 4–6,17,18 …”

Section: Discussiоnmentioning

confidence: 99%

Status of coronary disease and results from early endovascular aneurysm repair after preventive percutaneous coronary revascularization

Mannacio

Antignano³

et al. 2021

J Card Surg

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Background The incidence of coronary artery disease (CAD) is high in patients with an aortic aneurysm but preoperative routine coronary angiography and preventive coronary revascularization are not recommended to reduce cardiac events in patients with severe CAD. Aim This study evaluated the safeness and efficacy of preventive percutaneous coronary intervention (PCI) in patients with severe CAD scheduled for endovascular aneurysm repair (EVAR). Methods All patients with descending thoracic aneurysm (DTA) or abdominal aortic aneurysm (AAA) scheduled for EVAR underwent preliminary coronary angiography. Based on coronary angiography results, 917 patients (40.7%) had significant CAD and were treated by percutaneous coronary intervention (PCI; CAD group) and 1337 patients (59.3%) were without or with mild/moderate CAD and were considered as controls (no‐CAD group). To evaluate the safeness and efficacy of preventive PCI in patients with severe CAD undergoing EVAR, groups were compared for hospital and 12‐month cardiac adverse events. Results CAD was present in 1210 patients (53.6%): significant in 917 patients (38%) and mild to moderate in 293 patients (5.3%). Hospital and 12‐month cardiac events occurred in 15 (1.6%) and 13 (1.4%) CAD group patients and in 9 (0.7%) and 8 (0.4%) no‐CAD group patients (p = .05 and p = .08), respectively. Hospital and 12‐month cardiac deaths occurred in 3 (0.3%) and 2 (0.2%) CAD group patients and in 3 (0.2%) and 2 (0.2%) no‐CAD group patients (p = .9 and p = .9), respectively. Conclusion The strategy to treat severe CAD preoperatively by PCI and early subsequent EVAR brings a similar outcome to that in patients without or with mild/moderate CAD.

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“…Elderly patients undergoing non-cardiac surgery incidentally have severe aortic stenosis (AS). The current Japanese Circulation Society Guidelines indicate that patients undergoing non-cardiac surgery with symptomatic severe AS should be treated prior to non-cardiac surgery [1]. In the guidelines, echocardiography is recommended for patients with asymptomatic severe AS before non-cardiac surgery to determine cardiac function and the degree of invasion of the non-cardiac surgery.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of percutaneous transcatheter aortic valvuloplasty prior to non-cardiac surgery in Japanese patients with severe aortic stenosis

Takafuji

Hosokawa

Ogura

et al. 2019

Cardiovasc Interv and Ther

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This study aimed to investigate the efficacy of percutaneous transcatheter aortic valvuloplasty (PTAV) performed prior to non-cardiac surgery and the safety of non-cardiac surgery after PTAV in elderly Japanese patients. Between March 2012 and August 2018, 14 patients who underwent PTAVs prior to non-cardiac surgery were enrolled. The mean age was 82.2 ± 7.0 years. A total of 9 patients (64.3%) were women. A retrograde approach was selected for 57.1% of the patients. More than 75% of the procedures were performed using echocardiographic imaging. Echocardiographic data including the aortic valve area (AVA), peak aortic valve blood velocity flow (AVF), peak aortic valve pressure gradient (AVPG), and mean AVPG significantly improved after PTAV (AVA; from 0.54 ± 0.11 to 0.80 ± 0.13 cm2, peak AVF; from 4.6 ± 0.8 to 3.8 ± 0.7 m/s, peak AVG; from 87.9 ± 28.0 to 62.2 ± 19.9 mmHg, mean AVG; from 49.8 ± 18.9 to 35.7 ± 11.6 mmHg; p < 0.001, p < 0.001, p < 0.001, p = 0.0012, respectively). Neither complications related to the PTAV procedure nor procedural mortality were noted. Non-cardiac surgery after PTAV was safely performed; there were no significant adverse events during non-cardiac surgery and no in-hospital mortality occurred after non-cardiac surgery. PTAV prior to non-cardiac surgery in elderly Japanese patients with severe aortic stenosis is safe and effective. In addition, non-cardiac surgery after PTAV can be safety performed without adverse events.

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Guidelines for Perioperative Cardiovascular Evaluation and Management for Noncardiac Surgery (JCS 2014)　― Digest Version ―

Cited by 23 publications

References 111 publications

Hemorrhagic and Thromboembolic Complications after Hepato-Biliary-Pancreatic Surgery in Patients Receiving Antithrombotic Therapy

Hemorrhagic and Thromboembolic Complications after Hepato-Biliary-Pancreatic Surgery in Patients Receiving Antithrombotic Therapy

Status of coronary disease and results from early endovascular aneurysm repair after preventive percutaneous coronary revascularization

Efficacy and safety of percutaneous transcatheter aortic valvuloplasty prior to non-cardiac surgery in Japanese patients with severe aortic stenosis

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Guidelines for Perioperative Cardiovascular Evaluation and Management for Noncardiac Surgery (JCS 2014) ― Digest Version ―

Cited by 23 publications

References 111 publications

Hemorrhagic and Thromboembolic Complications after Hepato-Biliary-Pancreatic Surgery in Patients Receiving Antithrombotic Therapy

Hemorrhagic and Thromboembolic Complications after Hepato-Biliary-Pancreatic Surgery in Patients Receiving Antithrombotic Therapy

Status of coronary disease and results from early endovascular aneurysm repair after preventive percutaneous coronary revascularization

Efficacy and safety of percutaneous transcatheter aortic valvuloplasty prior to non-cardiac surgery in Japanese patients with severe aortic stenosis

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Guidelines for Perioperative Cardiovascular Evaluation and Management for Noncardiac Surgery (JCS 2014)　― Digest Version ―