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Preoperative cardiac evaluation of the vascular surgery patient-An anesthesia perspective

机译：血管外科手术患者的术前心脏评估-麻醉角度

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摘要

The morbidity and mortality associated with vascular surgery procedures are largely the results of cardiac events. National guidelines have been regularly proposed and updated by the American College of Cardiology (ACC)/American Heart Association (AHA) to ensure optimal perioperative management and risk stratification. Controversy remains between experts and other cardiology societies regarding several patient care issues including revascularization before surgery, timing of I-blocker therapy, and the administration of antiplatelet therapy. Several landmark articles recently published have helped to modify the guidelines in the hope of improving vascular patient outcomes. In this review, we searched all recent available literature pertaining to perioperative cardiac evaluation before major vascular surgery. We propose an algorithm for preoperative cardiac evaluation, which is a modification to the AHA recommendations. Incorporated in this algorithm are recent published pivotal articles that can help in guiding physicians caring for the vascular patient requiring major operative or endovascular interventions.
机译：与血管外科手术相关的发病率和死亡率在很大程度上是心脏事件的结果。美国心脏病学会（ACC）/美国心脏协会（AHA）定期提出并更新了国家指南，以确保最佳的围手术期管理和风险分层。在专家和其他心脏病学会之间，关于几个患者护理问题的争议仍然存在，包括手术前的血运重建，I受体阻滞剂治疗的时机以及抗血小板治疗的管理。最近发表的几篇具有里程碑意义的文章有助于修改指南，以期改善血管患者的预后。在这篇综述中，我们检索了所有有关大血管手术前围手术期心脏评估的文献。我们提出了一种术前心脏评估算法，该算法是对AHA建议的修改。该算法中并入了最近发表的重要文章，这些文章可以帮助指导医师照料需要大手术或血管内干预的血管患者。

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