Perioperative evaluation and management of cardiac risk in vascular surgery
2017
Cardiac complications are among the most common
causes of perioperative morbidity and mortality aer vascular surgery (Level 1).1 Studies have shown that such risk
is not limited to the perioperative period. As an example, long-term cardiovascular risk has been shown to be
greater in patients undergoing intervention for peripheral arterial disease (PAD), abdominal aortic aneurysm
(AAA) and carotid artery stenosis than for patients undergoing rst-time coronary angioplasty for coronary artery
disease (CAD) (Level 2).2 e reasons for the increased
cardiac risk are varied. Major arterial procedures oen
involve lengthy anesthetic times and can be associated
with substantial hemodynamic stress including uctuations in heart rate, systemic vascular resistance, intraand extravascular uid volume and blood pressure. Due
to the similarity of risk factors between PAD and CAD
(e.g. diabetes mellitus, dyslipidemia, smoking), patients
with PAD inevitably have concomitant CAD. Up to 70%
of patients with PAD have been shown to have concomitant CAD which increases the risk of perioperative myocardial ischemia, arrhythmia, congestive heart failure and
cardiac death (Level 1).3 Finally, many vascular patientswith severe CAD may not have overt cardiac symptoms
due to functionally limiting claudication.
Keywords:
- Correction
- Source
- Cite
- Save
- Machine Reading By IdeaReader
0
References
0
Citations
NaN
KQI