Preoperative evaluation and perioperative management of patients undergoing major vascular surgery

Patients undergoing major vascular surgery have an increased risk of perioperative major adverse cardiovascular events (MACE). Accordingly, in this population, it is of particular importance to appropriately risk stratify patients’ risk for these complications and optimize risk factors prior to surg...

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Published inVascular medicine (London, England) Vol. 27; no. 5; pp. 496 - 512
Main Authors Lee, Christopher, Columbo, Jesse A, Stone, David H, Creager, Mark A, Henkin, Stanislav
Format Journal Article
LanguageEnglish
Published London, England SAGE Publications 01.10.2022
Sage Publications Ltd
Subjects
Comorbidity
Congestive heart failure
Coronary artery
Coronary artery disease
Heart diseases
Patients
Review: Core Curriculum in Vascular Medicine
Risk analysis
Risk factors
Surgery
cardiac risk index
major adverse cardiovascular events
perioperative management
pre-operative evaluation
major vascular surgery
Online AccessGet full text
ISSN1358-863X
1477-0377
1477-0377
DOI10.1177/1358863X221122552

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Abstract Patients undergoing major vascular surgery have an increased risk of perioperative major adverse cardiovascular events (MACE). Accordingly, in this population, it is of particular importance to appropriately risk stratify patients’ risk for these complications and optimize risk factors prior to surgical intervention. Comorbidities that portend a higher risk of perioperative MACE include coronary artery disease, heart failure, left-sided valvular heart disease, and significant arrhythmic burden. In this review, we provide a current approach to risk stratification prior to major vascular surgery and describe the strengths and weaknesses of different cardiac risk indices; discuss the role of noninvasive and invasive cardiac testing; and review perioperative pharmacotherapies.
AbstractList Patients undergoing major vascular surgery have an increased risk of perioperative major adverse cardiovascular events (MACE). Accordingly, in this population, it is of particular importance to appropriately risk stratify patients’ risk for these complications and optimize risk factors prior to surgical intervention. Comorbidities that portend a higher risk of perioperative MACE include coronary artery disease, heart failure, left-sided valvular heart disease, and significant arrhythmic burden. In this review, we provide a current approach to risk stratification prior to major vascular surgery and describe the strengths and weaknesses of different cardiac risk indices; discuss the role of noninvasive and invasive cardiac testing; and review perioperative pharmacotherapies.
Patients undergoing major vascular surgery have an increased risk of perioperative major adverse cardiovascular events (MACE). Accordingly, in this population, it is of particular importance to appropriately risk stratify patients’ risk for these complications and optimize risk factors prior to surgical intervention. Comorbidities that portend a higher risk of perioperative MACE include coronary artery disease, heart failure, left-sided valvular heart disease, and significant arrhythmic burden. In this review, we provide a current approach to risk stratification prior to major vascular surgery and describe the strengths and weaknesses of different cardiac risk indices; discuss the role of noninvasive and invasive cardiac testing; and review perioperative pharmacotherapies.
Patients undergoing major vascular surgery have an increased risk of perioperative major adverse cardiovascular events (MACE). Accordingly, in this population, it is of particular importance to appropriately risk stratify patients' risk for these complications and optimize risk factors prior to surgical intervention. Comorbidities that portend a higher risk of perioperative MACE include coronary artery disease, heart failure, left-sided valvular heart disease, and significant arrhythmic burden. In this review, we provide a current approach to risk stratification prior to major vascular surgery and describe the strengths and weaknesses of different cardiac risk indices; discuss the role of noninvasive and invasive cardiac testing; and review perioperative pharmacotherapies.Patients undergoing major vascular surgery have an increased risk of perioperative major adverse cardiovascular events (MACE). Accordingly, in this population, it is of particular importance to appropriately risk stratify patients' risk for these complications and optimize risk factors prior to surgical intervention. Comorbidities that portend a higher risk of perioperative MACE include coronary artery disease, heart failure, left-sided valvular heart disease, and significant arrhythmic burden. In this review, we provide a current approach to risk stratification prior to major vascular surgery and describe the strengths and weaknesses of different cardiac risk indices; discuss the role of noninvasive and invasive cardiac testing; and review perioperative pharmacotherapies.
Author Stone, David H
Lee, Christopher
Henkin, Stanislav
Columbo, Jesse A
Creager, Mark A
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  organization: Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
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Issue 5
Keywords cardiac risk index
major adverse cardiovascular events
perioperative management
pre-operative evaluation
major vascular surgery
Language English
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Snippet Patients undergoing major vascular surgery have an increased risk of perioperative major adverse cardiovascular events (MACE). Accordingly, in this population,...
Patients undergoing major vascular surgery have an increased risk of perioperative major adverse cardiovascular events (MACE). Accordingly, in this population,...
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SubjectTerms Comorbidity
Congestive heart failure
Coronary artery
Coronary artery disease
Heart diseases
Patients
Review: Core Curriculum in Vascular Medicine
Risk analysis
Risk factors
Surgery
Title Preoperative evaluation and perioperative management of patients undergoing major vascular surgery
URI https://journals.sagepub.com/doi/full/10.1177/1358863X221122552
https://www.proquest.com/docview/2723046994
https://www.proquest.com/docview/2723483201
https://pubmed.ncbi.nlm.nih.gov/PMC9551317
Volume 27
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