Differentiated Prevention of Cardiac Complications of Extracardiac Surgery
Due to population aging in developed countries, there are increasingly more patients with cardiovascular comorbidities in anesthesiological care. The frequency of cardiac complications of extracardiac surgery is 1.4% in patients over age 50 years following elective noncardiac surgery and amounts to...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
2011-10-01
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| Series: | Общая реаниматология |
| Online Access: | https://www.reanimatology.com/rmt/article/view/269 |
| _version_ | 1797874298944225280 |
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| author | A. N. Korniyenko O. R. Dobrushina E. P. Zinina |
| author_facet | A. N. Korniyenko O. R. Dobrushina E. P. Zinina |
| author_sort | A. N. Korniyenko |
| collection | DOAJ |
| description | Due to population aging in developed countries, there are increasingly more patients with cardiovascular comorbidities in anesthesiological care. The frequency of cardiac complications of extracardiac surgery is 1.4% in patients over age 50 years following elective noncardiac surgery and amounts to 26.6% in those aged over 85 years after emergency abdominal operations. The review considers the causes, methods for prediction and prevention of cardiac complications of extracardiac surgery. The latter were divided into 3 types: 1) coronary complications due to the inconsistency of oxygen delivery and consumption; 2) coronary ones due to atherosclerotic plaque rupture, followed by coronary artery thrombosis; 3) worsening heart failure. To predict different types of complications, one must focus attention on the following signs and, if needed, perform additional studies: 1) the functional class of exertional angina, stress tests (stress echocardiography using dobutamine or other agents), coronary angiography, and blood troponin T and I levels for Type 1; 2) the signs of the extent of the atherosclerotic process and the blood levels of C-reactive protein and other inflammatory markers for Type 2; 3) the clinical signs of heart failure and the blood levels of natriuretic peptides for Type 3. Special scales (developed by Lee, Goldman, Detsky, et al.) may be also used to assess cardiovascular risk. For prevention of the complications, one may use a wide range of procedures: surgical myocardial revascularization, use of beta-adrenoblockers, and correction of hemodynamic disorders under invasive monitoring for Type 1; prescription of antiaggregants and statins for Type 2; limitation of infusion load, administration of levosimendan, and correction of hemodynamic disorders under invasive monitoring for Type 3. Key words: cardiovascular diseases, heart failure, coronary heart disease, cardiac complications, surgical risk assessment. |
| first_indexed | 2024-04-10T01:29:45Z |
| format | Article |
| id | doaj.art-c7b6cdc5ecfd402da19e6962ac713324 |
| institution | Directory Open Access Journal |
| issn | 1813-9779 2411-7110 |
| language | English |
| last_indexed | 2024-04-10T01:29:45Z |
| publishDate | 2011-10-01 |
| publisher | Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia |
| record_format | Article |
| series | Общая реаниматология |
| spelling | doaj.art-c7b6cdc5ecfd402da19e6962ac7133242023-03-13T09:32:51ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102011-10-017510.15360/1813-9779-2011-5-57269Differentiated Prevention of Cardiac Complications of Extracardiac SurgeryA. N. KorniyenkoO. R. DobrushinaE. P. ZininaDue to population aging in developed countries, there are increasingly more patients with cardiovascular comorbidities in anesthesiological care. The frequency of cardiac complications of extracardiac surgery is 1.4% in patients over age 50 years following elective noncardiac surgery and amounts to 26.6% in those aged over 85 years after emergency abdominal operations. The review considers the causes, methods for prediction and prevention of cardiac complications of extracardiac surgery. The latter were divided into 3 types: 1) coronary complications due to the inconsistency of oxygen delivery and consumption; 2) coronary ones due to atherosclerotic plaque rupture, followed by coronary artery thrombosis; 3) worsening heart failure. To predict different types of complications, one must focus attention on the following signs and, if needed, perform additional studies: 1) the functional class of exertional angina, stress tests (stress echocardiography using dobutamine or other agents), coronary angiography, and blood troponin T and I levels for Type 1; 2) the signs of the extent of the atherosclerotic process and the blood levels of C-reactive protein and other inflammatory markers for Type 2; 3) the clinical signs of heart failure and the blood levels of natriuretic peptides for Type 3. Special scales (developed by Lee, Goldman, Detsky, et al.) may be also used to assess cardiovascular risk. For prevention of the complications, one may use a wide range of procedures: surgical myocardial revascularization, use of beta-adrenoblockers, and correction of hemodynamic disorders under invasive monitoring for Type 1; prescription of antiaggregants and statins for Type 2; limitation of infusion load, administration of levosimendan, and correction of hemodynamic disorders under invasive monitoring for Type 3. Key words: cardiovascular diseases, heart failure, coronary heart disease, cardiac complications, surgical risk assessment.https://www.reanimatology.com/rmt/article/view/269 |
| spellingShingle | A. N. Korniyenko O. R. Dobrushina E. P. Zinina Differentiated Prevention of Cardiac Complications of Extracardiac Surgery Общая реаниматология |
| title | Differentiated Prevention of Cardiac Complications of Extracardiac Surgery |
| title_full | Differentiated Prevention of Cardiac Complications of Extracardiac Surgery |
| title_fullStr | Differentiated Prevention of Cardiac Complications of Extracardiac Surgery |
| title_full_unstemmed | Differentiated Prevention of Cardiac Complications of Extracardiac Surgery |
| title_short | Differentiated Prevention of Cardiac Complications of Extracardiac Surgery |
| title_sort | differentiated prevention of cardiac complications of extracardiac surgery |
| url | https://www.reanimatology.com/rmt/article/view/269 |
| work_keys_str_mv | AT ankorniyenko differentiatedpreventionofcardiaccomplicationsofextracardiacsurgery AT ordobrushina differentiatedpreventionofcardiaccomplicationsofextracardiacsurgery AT epzinina differentiatedpreventionofcardiaccomplicationsofextracardiacsurgery |