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Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
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The patient with chronic heart failure undergoing surgery
Valérie Smit-Fun1, Wolfgang F Buhre
1aDepartment of Anesthesiology and Pain Medicine, Maastricht University Medical Center+ bSchool for Mental Health and Neuroscience (MheNS), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, The Netherlands.
Current Opinion in Anaesthesiology
|March 16, 2016
Summary
Congestive heart failure (CHF) significantly increases perioperative risks. Reduced ejection fraction (<30%) is linked to higher mortality and heart attacks, necessitating improved preoperative assessment and tailored therapies.
Area of Science:
- Cardiology
- Anesthesiology
- Geriatrics
Background:
- Congestive heart failure (CHF) is prevalent in elderly patients.
- Approximately 50% of CHF patients have reduced left ventricular ejection fraction.
- Perioperative mortality is elevated in patients with CHF undergoing surgery.
Purpose of the Study:
- Summarize recent literature on CHF and perioperative outcomes.
- Emphasize current guidelines, preoperative assessment, and perioperative therapy.
- Highlight new insights from the past 18 months.
Main Methods:
- Review of recent literature on CHF and perioperative outcomes.
- Analysis of new guidelines from the European Society of Anesthesiology.
- Discussion of risk stratification using parameters like brain natriuretic peptide.
Main Results:
- Ejection fraction <30% is associated with increased mortality and myocardial infarctions.
- Acute heart failure exacerbation occurs in 25% of patients perioperatively.
- New guidelines emphasize preoperative evaluation and risk stratification.
Conclusions:
- CHF contributes significantly to perioperative morbidity and mortality.
- Knowledge regarding CHF in non-cardiac surgery is limited.
- Urgent research is needed to improve perioperative care for CHF patients.
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