Cardiovascular Risk in Non-cardiac Surgery

2013 ◽  
pp. 75-81
Author(s):  
Luca Ferdinando Lorini ◽  
Lorenzo Filippo Mantovani
Keyword(s):  
Cardiac Surgery ◽  
Cardiovascular Risk

scholarly journals Strategy of Medical Care for Pregnant Women with Congenital Heart Disease

2021 ◽  
pp. 64-69
Author(s):  
S. O. Siromakha ◽  
Yu. V. Davydova ◽  
A. O. Tarnavska ◽  
N. I. Volkova ◽  
N. B. Nakonechna
Keyword(s):  
Cardiac Surgery ◽  
Cardiovascular Risk ◽  
Medical Care ◽  
Pregnant Women ◽  
Postpartum Period ◽  
Congenital Heart ◽  
Adverse Outcomes ◽  
Long Term Results ◽  
Increased Risk

Grown-up congenital heart (GUCH) is a global challenge nowadays. The strategy of medical care for GUCH women dur-ing pregnancy, childbirth and the postpartum period is a topic of active discussion in the expert community. These patients have significantly increased risk of maternal and perinatal loss. A national obstetric cardiology and cardiac surgery multi-disciplinary team (OCCS) established in academic institutions in 2013 has provided medical support to 896 GUCH pregnant women over the last 7 years. In total, GUCH patients accounted for 36% of the cohort of all the examined pregnant women. Of these, 474 (53%) were primigravid. The mean age of the patients at the time of the first visit was 27.3 ± 5.7 years. Patients with uncorrected CHD accounted for 66.2% (n = 593), and 33.8% (n = 303) of pregnant women had undergone correction, including hemodynamic correction of complex CHD in 5 patients. Risk stratification was performed using several scores (mWHO, ZAHARA, CARPREG) for the comprehensive assessment of cardiovascular risk and prediction of pregnancy, deliv-ery, and postpartum period course. 82 patients were classified as having high cardiovascular risk (CVR) after the stratifica-tion. They needed admission to the cardiac surgery facility to receive different types of medical care. There were 2 (2.4%) cases of maternal loss and 3 (3.8%) cases of adverse perinatal outcomes in this group of patients. The article presents the algorithms for multidisciplinary care strategy choice in GUCH pregnant women with high CVR and their routing principles developed by the OCCS. These algorithms significantly reduced adverse outcomes of pregnancy and childbirth in this group of patients. Long-term results were evaluated in 69 patients (86.3%). The follow-up period ranged from 1 to 91 months, on average 34.4 ± 23.6 months. There were no long-term maternal losses or repeated cardiac surgeries. There was one case of unexplained death of a child 8 months after birth. The strategy of multidisciplinary medical care of a high-class GUCH pregnant woman should be personalized depending on the clinical data and in accordance with the ESC 2018 guidelines.

scholarly journals Lesión miocárdica perioperatoria en cirugía no cardiaca

2020 ◽  
Vol 12 (2) ◽  
pp. 3
Author(s):  
Daniel Paz Martín
Keyword(s):  
Cardiac Surgery ◽  
Cardiovascular Risk ◽  
Myocardial Injury ◽  
The Other ◽  
High Cardiovascular Risk ◽  
One Year ◽  
The One

La lesión miocárdica perioperatoria (LMP) en cirugía no cardiaca es una complicación, a menudo no identificada, que se relaciona con un aumento de mortalidad a 30 días. Los objetivos del presente trabajo son por una parte, conocer la incidencia de LMP, que se encuentra entorno al 16% en pacientes de alto riesgo cardiovascular. Por otra, evaluar su relación con la mortalidad a 30 días y un año; la presencia de LMP se asocia a una mayor mortalidad. ABSTRACT Perioperative myocardial injury in non-cardiac surgery Perioperative myocardial injury (PMI) in non-cardiac surgery is a complication, often not identified, that is related to an increase in mortality at 30 days. The objectives of this study are, on the one hand, to know the incidence of PMI, which is around 16% in patients with a high cardiovascular risk. On the other, evaluate its relationship with mortality at 30 days and one year; the presence of PMI is associated with increased mortality.

scholarly journals Trends in cardiovascular risk factor and disease prevalence in patients undergoing non-cardiac surgery

Heart ◽  
2018 ◽  
Vol 104 (14) ◽  
pp. 1180-1186 ◽  
Author(s):  
Nathaniel R Smilowitz ◽  
Navdeep Gupta ◽  
Yu Guo ◽  
Joshua A Beckman ◽  
Sripal Bangalore ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiac Surgery ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Prior Stroke ◽  
Over Time

ObjectivesCardiovascular risk factors are prevalent in the population undergoing non-cardiac surgery. Changes in perioperative cardiovascular risk factor profiles over time are unknown. The objective of this study was to evaluate national trends in cardiovascular risk factors and atherosclerotic cardiovascular disease (ASCVD) among patients undergoing non-cardiac surgery.MethodsAdults aged ≥45 years old who underwent non-cardiac surgery were identified using the US National Inpatient Sample from 2004 to 2013. The prevalence of traditional cardiovascular risk factors (hypertension, dyslipidaemia, diabetes mellitus, obesity and chronic kidney disease) and ASCVD (coronary artery disease, peripheral artery disease and prior stroke] were evaluated over time.ResultsA total of 10 581 621 hospitalisations for major non-cardiac surgery were identified. Between 2008 and 2013, ≥2 cardiovascular risk factors and ASCVD were present in 44.5% and 24.3% of cases, respectively. Over time, the prevalence of multiple (≥2) cardiovascular risk factors increased from 40.5% in 2008–2009 to 48.2% in 2012–2013, P<0.001. The proportion of patients with coronary artery disease (17.2% in 2004–2005 vs 18.2% in 2012–2013, P<0.001), peripheral artery disease (6.3% in 2004–2005 vs 7.4% in 2012–2013, P<0.001) and prior stroke (3.5% in 2008–2009 vs 4.7% 2012–2013, P<0.001) also increased over time. The proportion of patients with a modified Revised Cardiac Risk Index score ≥3 increased from 6.6% in 2008–2009 to 7.7% in 2012–2013 (P<0.001).ConclusionsAmong patients undergoing major non-cardiac surgery, the burden of cardiovascular risk factors and the prevalence of ASCVD increased over time. Adverse trends in risk profiles require continued attention to improve perioperative cardiovascular outcomes.

scholarly journals Preoperative Cardiovascular Risk Assessment Prior Non Cardiac Surgery: A Case Series of Patients Undergoing Urological Surgery in Ngaoundere, Cameroon

2020 ◽  
Vol 10 (07) ◽  
pp. 446-454
Author(s):  
Olivier Pancha Mbouemboue ◽  
Herman Cabrel Ngangao ◽  
Jacques Olivier Ngoufack Tsougmo ◽  
Emmanuel Balep ◽  
Franklin Ndanki ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Cardiac Surgery ◽  
Cardiovascular Risk ◽  
Case Series ◽  
Cardiovascular Risk Assessment ◽  
Urological Surgery

scholarly journals Assessment of cardiovascular risk and prevention of complications in non-cardiac surgery in patients with coronary heart disease

2021 ◽  
Vol 26 (6) ◽  
pp. 629-639
Author(s):  
A. V. Panov ◽  
E. V. Kuleshova ◽  
N. L. Lokhovinina ◽  
M. Z. Alugishvili ◽  
I. T. Abesadze ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiovascular Risk ◽  
Drug Therapy ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Coronary Revascularization ◽  
Coronary Intervention ◽  
Individual Risk ◽  
Stress Tests ◽  
Converting Enzyme Inhibitors

The incidence of cardiovascular complications in non-cardiac surgery is about 3 %. The review presents the data on the assessment of cardiovascular risk (CVR) in non-cardiac surgery. The algorithm of decisionmaking considers the functional state of the patient and the category of CVR of the upcoming surgery. Functional testing is not indicated for patients with low CVR. Stress tests should be considered in high-risk patients if the test results may change the perioperative drug therapy, the method of anesthesia, or the surgical approach. Routine coronary revascularization does not reduce perioperative risks and is used for special indications. Percutaneous coronary intervention and associated dual antiplatelet therapy may delay the timing of non-cardiac operations. Perioperative drug therapy (beta-blockers, aspirin, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and statins) should be prescribed taking into account the individual risk of the patient.

Sign in / Sign up

Export Citation Format

Share Document