Preoperative Cardiac Evaluation and Management of the Patient Undergoing Major Vascular Surgery

Duncan, Dallas; Wijeysundera, Duminda N.

doi:10.1097/aia.0000000000000091

Cited by 20 publications

(13 citation statements)

References 151 publications

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“…Die präoperative Evaluation durch den Anästhesisten ist das zentrale Element bei der Risikoeinschätzung des individuellen Patienten [10] insbesondere für Hochrisikopatienten vor komplexen chirurgischen Eingriffen [11].…”

Section: Präoperative Evaluation In Der Anästhesieambulanzunclassified

Anästhesie und Outcome: Einfluss der perioperativen Prozesse

Zieger¹,

Häberle²

2017

Anästhesiol Intensivmed Notfallmed Schmerzther

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In recent years, the role of the anesthesiologist has turned tremendously from the "anaesthesia doctor" into a perioperative physician and risk specialist. Patients are older, multimorbid, and are called up for more and more extensive surgery and interventions. Socioeconomic aspects have grown in importance. The anesthesiologist, paving the way for a good outcome, is involved in nearly all perioperative processes: preoperative evaluation, definition and optimization of preoperative and intraoperative conditions, management of modern intraoperative anesthesia as well as postoperative medically indicated, effective and efficient treatment of partially highly complex patients. The individual perioperative process steps in this way are examined in accordance with established guidelines and the increase in current requirements. Finally, a special emphasis is placed on the perception that the perioperative process has not been completed with the end of surgery - postoperative outcome is not least adversely affected by postoperative complications on the normal ward. The risk of death after complications, "failure to rescue", should be identified early and treated promptly.

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Section: Präoperative Evaluation In Der Anästhesieambulanzunclassified

Anästhesie und Outcome: Einfluss der perioperativen Prozesse

Zieger¹,

Häberle²

2017

Anästhesiol Intensivmed Notfallmed Schmerzther

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“…The CARP trial focused on patients who had stable CAD and those without left main coronary disease or significant valvular heart disease. Time to vascular surgery was significantly longer in the revascularization group [52,53]. Although this evidence is encouraging, caution is warranted.…”

Section: Impact Of Coronary Revascularization Decision On Noncardiac mentioning

confidence: 79%

Cardiovascular Risk Evaluation in Patients with Critical Leg Ischemia before Vascular Surgery

Stoia¹,

Mocan²,

Goidescu³

et al. 2018

Peripheral Arterial Disease - A Practical Approach

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Assessment of the role and investigation particularities (comparative and complementary aspects, hierarchies, preferential indication) adapted to the context of a global cardiovascular (CV) evaluation, including clinical elements, non-invasive and invasive imagistic examination in order to estimate the cardiovascular risk (CVR) and to define the revascularization therapeutic strategy in patients with critical leg ischemia (CLI). Complete and accessible evaluation involves accessible means of investigation like clinical exam, electrocardiogram, cardiac biomarkers, arterial, cardiac, and carotid ultrasonography which could be affordable in all cardiovascular departments. Non-invasive stress tests, coronary and arterial cervical angiography imaging leads in selected cases and where is possible to the identification of significant coronary and/or carotid lesions potential responsible for cardiac and cerebrovascular events after vascular surgery. The evaluation algorithm allows better risk stratification of patients with CLI in high and intermediate CVR. The "poly-arterial" status in patients with CLI changes the intervention management with a more intensive pre-operative medical treatment, while the coronary and the carotid arteries revascularization might precedes the peripheral arterial revascularization procedures, in order to reduce the CV risk status.

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“…It is possible to encounter predisposing factors or cardiac pathologies in every age group; however, all these situations do not always cause ECG changes in the preoperative period and unfortunately the majority of the time arrhythmias occur unexpectedly (Mandim et al, 2004). Preoperative assessment should determine firstly the patient's history, medications used, biochemical values and predisposing factors for arrhythmia (Duncan and Wijeysundera, 2016). Patients in the risk group should have detailed assessment and then consultation with cardiology and it is important to prepare the patient in the best conditions for surgery and share risks based on this recommendation.…”

Section: Cardiopulmonary Resuscitation and Defibrillationmentioning

confidence: 99%

Perioperative arrhythmias

Altınbaş

Taş

Bektaş

2017

Middle Black Sea Journal of Health Science

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Arrhythmias are the most commonly encountered cardiovascular complications during anesthesia administration. Perioperative arrhythmias disrupt the hemodynamic state of the patients and are known to cause increases in mortality and morbidity. Anesthetic agents and methods affect cardiac conduction and cause arrhythmia. At the same time, patients with additional cardiac diseases and other systemic diseases affecting the cardiovascular system have increased risk of perioperative arrhythmia. For the patient, regardless of whether due to the surgical procedure or anesthesia type, the most important effect of intraoperative arrhythmias is undoubtedly the resulting hemodynamic instability. It is possible to encounter a broad range of serious rhythm and hemodynamic disorders from rare ventricular extrasystole to malignant character arrhythmia and sudden cardiac arrest. Temperature changes occurring in the intraoperative period, hypoxia, acid-base disorders and variations in electrolyte balance are significant factors affecting the occurrence of arrhythmia. As there are many factors and mechanisms in the etiology, identifying arrhythmia under anesthesia and performing the necessary intervention in the shortest time possible has vital importance. This review deals with the importance of arrhythmia occurring in the perioperative period and methods of approach for arrhythmia.

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Preoperative Cardiac Evaluation and Management of the Patient Undergoing Major Vascular Surgery

Cited by 20 publications

References 151 publications

Anästhesie und Outcome: Einfluss der perioperativen Prozesse

Anästhesie und Outcome: Einfluss der perioperativen Prozesse

Cardiovascular Risk Evaluation in Patients with Critical Leg Ischemia before Vascular Surgery

Perioperative arrhythmias

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