Management during non-cardiac surgery

The risk of cardiovascular complications in patients undergoing non-cardiac surgery depends risk on the type of non-cardiac surgery, classified into 3 groups, and the type and severity of valvular disease. The risk of complications is highest in aortic stenosis In symptomatic patients, aortic stenosis should be treated before non-cardiac surgery, while asymptomatic patients with severe aortic stenosis can undergo elective non-cardiac surgery. In symptomatic patients with mitral stenosis, percutaneous mitral commissurotomy should be attempted before high-risk non-cardiac surgery. In asymptomatic patients with severe regurgitation and preserved left ventricular systolic function, non-cardiac surgery can be performed safely. In patients with mechanical prosthesis, the main problem is the adaptation of the modalites of anticoagulant therapy.