Preoperative Cardiovascular Assessment in Non-Cardiac Procedure
Keywords:
perioperative risk, non-cardiac procedure, preoperative assessment, revised cardiac risk index, preoperative medication, shared-care modelAbstract
Non-cardiac procedures are performed increasingly every year. As a result, some patients develop cardiovascular complication which ultimately cause morbidity and mortality. Assessing the patients’ risk and optimal preoperative management are the best way to prevent the complication. Nowadays, there are many academic associates launch the perioperative assessment and management guidelines which there are some different details in each guideline, but the overall content remains the same. Each guideline emphasizes on stepwise assessment starting from urgency of procedure, unstable cardiac conditions, procedural cardiovascular risks. If the patients have significant cardiovascular risks and are being performed on quite high surgical risks procedure. They will be further worked up on some laboratory investigation, administering some medication or performing some procedures before. The key point to assess and manage these group of patients is “shared-care-model” which is the consensus between internists, surgeons, and anesthesiologists for the best practice in each patient to reduce cardiovascular morbidity and mortality as much as possible.
References
Weiser TG, Haynes AB, Molina G, et al. Estimate of the global volume of surgery in 2012: an assessment supporting improved health outcomes. Lancet Lond Engl. 2015;385 Suppl 2:S11. https://doi.org/10.1016/S0140-6736(15)60806-6
Haynes AB, Weiser TG, Berry WR, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009;360(5):491-499. https://doi.org/10.1056/NEJMsa0810119
Botto F, Alonso-Coello P, Chan MTV, et al. Myocardial injury after noncardiac surgery: a large, international, prospective cohort study establishing diagnostic criteria, characteristics, predictors, and 30-day outcomes. Anesthesiology. 2014;120(3):564-578. https://doi.org/10.1097/ALN.0000000000000113
Devereaux PJ, Mrkobrada M, Sessler DI, et al. Aspirin in Patients Undergoing Noncardiac Surgery. N Engl J Med. 2014;370(16):1494-1503. https://doi.org/10.1056/NEJMoa1401105
Ja van W, Hm N, Jc de G, et al. Myocardial injury after noncardiac surgery and its association with short-term mortality. Circulation. 2013;127(23):2264-2271. https://doi.org/10.1161/CIRCULATIONAHA.113.002128
Mangano DT. Perioperative medicine: NHLBI working group deliberations and recommendations. J Cardiothorac Vasc Anesth. 2004;18(1):1-6. https://doi.org/10.1053/j.jvca.2003.10.002
Fleisher LA, Fleischmann KE, Auerbach AD, et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014;64(22):e77-137. https://doi.org/10.1016/j.jacc.2014.07.944
Glance LG, Lustik SJ, Hannan EL, et al. The Surgical Mortality Probability Model: derivation and validation of a simple risk prediction rule for noncardiac surgery. Ann Surg. 2012;255(4):696-702. https://doi.org/10.1097/SLA.0b013e31824b45af
Donati A, Ruzzi M, Adrario E, et al. A new and feasible model for predicting operative risk. Br J Anaesth. 2004;93(3):393-399. https://doi.org/10.1093/bja/aeh210
Eagle KA, Berger PB, Calkins H, et al. ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). J Am Coll Cardiol. 2002;39(3):542-553. https://doi.org/10.1016/s0735-1097(01)01788-0
Kristensen SD, Knuuti J, Saraste A, et al. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J. 2014;35(35):2383-2431. https://doi.org/10.1093/eurheartj/ehu282
Duceppe E, Parlow J, MacDonald P, et al. Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery. Can J Cardiol. 2017;33(1):17-32. https://doi.org/10.1016/j.cjca.2016.09.008
Roshanov PS, Rochwerg B, Patel A, et al. Withholding versus Continuing Angiotensin-converting Enzyme Inhibitors or Angiotensin II Receptor Blockers before Noncardiac Surgery: An Analysis of the Vascular events In noncardiac Surgery patIents cOhort evaluatioN Prospective Cohort. Anesthesiology. 2017;126(1):16-27. https://doi.org/10.1097/ALN.0000000000001404
Antoniou GA, Chalmers N, Georgiadis GS, et al. A meta-analysis of endovascular versus surgical reconstruction of femoropopliteal arterial disease. J Vasc Surg. 2013;57(1):242-253. https://doi.org/10.1016/j.jvs.2012.07.038
Aboyans V, Ricco J-B, Bartelink M-LEL, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018;39(9):763-816. https://doi.org/10.1093/eurheartj/ehx095
Paravastu SCV, Jayarajasingam R, Cottam R, Palfreyman SJ, Michaels JA, Thomas SM. Endovascular repair of abdominal aortic aneurysm. Cochrane Database Syst Rev. 2014;(1). https://doi.org/10.1002/14651858.CD004178.pub2
Holte K, Kehlet H. Postoperative ileus: a preventable event. Br J Surg. 2000;87(11):1480-1493. https://doi.org/10.1046/j.1365-2168.2000.01595.x
Hirvonen EA, Nuutinen LS, Kauko M. Hemodynamic changes due to Trendelenburg positioning and pneumoperitoneum during laparoscopic hysterectomy. Acta Anaesthesiol Scand. 1995;39(7):949-955. https://doi.org/10.1111/j.1399-6576.1995.tb04203.x
Ainsworth BE, Haskell WL, Herrmann SD, et al. 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;43(8):1575-1581. https://doi.org/10.1249/MSS.0b013e31821ece12
Biccard BM. Relationship between the inability to climb two flights of stairs and outcome after major non-cardiac surgery: implications for the pre-operative assessment of functional capacity. Anaesthesia. 2005;60(6):588-593. https://doi.org/10.1111/j.1365-2044.2005.04181.x
Wijeysundera DN, Pearse RM, Shulman MA, et al. Measurement of Exercise Tolerance before Surgery (METS) study: a protocol for an international multicentre prospective cohort study of cardiopulmonary exercise testing prior to major non-cardiac surgery. BMJ Open. 2016;6(3):e010359. https://doi.org/10.1136/bmjopen-2015-010359
Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999;100(10):1043-1049. https://doi.org/10.1161/01.cir.100.10.1043
Ky B, Y L, Jl P, et al. Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons. J Am Coll Surg. 2013;217(5). https://doi.org/10.1016/j.jamcollsurg.2013.07.385
Gupta PK, Gupta H, Sundaram A, et al. Development and validation of a risk calculator for prediction of cardiac risk after surgery. Circulation. 2011;124(4):381-387. https://doi.org/10.1161/CIRCULATIONAHA.110.015701
Rodseth RN, Biccard BM, Le Manach Y, et al. The prognostic value of pre-operative and post-operative B-type natriuretic peptides in patients undergoing noncardiac surgery: B-type natriuretic peptide and N-terminal fragment of pro-B-type natriuretic peptide: a systematic review and individual patient data meta-analysis. J Am Coll Cardiol. 2014;63(2):170-180. https://doi.org/10.1016/j.jacc.2013.08.1630
Healy KO, Waksmonski CA, Altman RK, Stetson PD, Reyentovich A, Maurer MS. Perioperative outcome and long-term mortality for heart failure patients undergoing intermediate- and high-risk noncardiac surgery: impact of left ventricular ejection fraction. Congest Heart Fail Greenwich Conn. 2010;16(2):45-49. https://doi.org/10.1111/j.1751-7133.2009.00130.x
Park S-J, Choi J-H, Cho S-J, et al. Comparison of transthoracic echocardiography with N-terminal pro-brain natriuretic Peptide as a tool for risk stratification of patients undergoing major noncardiac surgery. Korean Circ J. 2011;41(9):505-511. https://doi.org/10.4070/kcj.2011.41.9.505
McFalls EO, Ward HB, Moritz TE, et al. Coronary-artery revascularization before elective major vascular surgery. N Engl J Med. 2004;351(27):2795-2804. https://doi.org/10.1056/NEJMoa041905
Patel MR, Calhoon JH, Dehmer GJ, et al. ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2017 Appropriate Use Criteria for Coronary Revascularization in Patients With Stable Ischemic Heart Disease : A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society of Thoracic Surgeons. J Nucl Cardiol Off Publ Am Soc Nucl Cardiol. 2017;24(5):1759-1792. https://doi.org/10.1007/s12350-017-0917-9
Neumann F-J, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2019;40(2):87-165. https://doi.org/10.1093/eurheartj/ehy394
Bouri S, Shun-Shin MJ, Cole GD, Mayet J, Francis DP. Meta-analysis of secure randomised controlled trials of β-blockade to prevent perioperative death in non-cardiac surgery. Heart Br Card Soc. 2014;100(6):456-464. https://doi.org/10.1136/heartjnl-2013-304262
Rm C, Pk W. Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Synopsis of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline. Ann Intern Med. 2018;168(5):351-358. https://doi.org/10.7326/M17-3203
Wijeysundera DN, Bender JS, Beattie WS. Alpha-2 adrenergic agonists for the prevention of cardiac complications among patients undergoing surgery. Cochrane Database Syst Rev. 2009;(4):CD004126. https://doi.org/10.1002/14651858.CD004126.pub2
Devereaux PJ, Sessler DI, Leslie K, et al. Clonidine in patients undergoing noncardiac surgery. N Engl J Med. 2014;370(16):1504-1513. https://doi.org/10.1056/NEJMoa1401106
Lindenauer PK, Pekow P, Wang K, Gutierrez B, Benjamin EM. Lipid-lowering therapy and in-hospital mortality following major noncardiac surgery. JAMA. 2004;291(17):2092-2099. https://doi.org/10.1001/jama.291.17.2092
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