Assessment of cardiac risk before non-cardiac general surgery
1 Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
2 Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
3 Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, the Netherlands
Correspondence to:
Correspondence to:
Professor Don Poldermans
Department of Vascular Surgery, Room H 921, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; d.poldermans@erasmusmc.nl
Keywords: perioperative care; cardiac assessment; non-cardiac surgery
| The first 150 words of the full text of this article appear below. |
Developments in anaesthetic and surgical techniques—that is, loco-regional anaesthesia and minimally invasive surgery—have improved postoperative cardiac outcome considerably in recent years. For example, patients with a severely reduced left ventricular function used to be at increased risk, but because of the implementation of these new techniques they are now scheduled for surgery at relatively low risk. In other words, the improvement of perioperative care has altered the impact of established cardiac risk factors.
However, as more patients with cardiac co-morbidity survive surgery, long-term cardiac outcome has gained interest. Therefore, the focus of preoperative risk evaluation should also take into consideration the impact of cardiac co-morbidity on long-term survival. After all, patients should live long enough to enjoy the benefits of surgery.
It is estimated that the incidence of cardiac complications after non-cardiac surgical procedures is between 0.5–1.0%.1,2 Annually around 100 million adults undergo some form of non-cardiac surgery. Consequently, approximately
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