[Management of Patients with Cardiac Failure Undergoing General Thoracic Surgery]

Recent changes in the demographics of surgical candidates, in terms of age, have increased the number of patients with surgical risk factors. In patients with preoperative cardiac diseases such as myocardial ischemia, arrhythmia, or congestive heart failure, it is important to offer any necessary preoperative medical examinations and treatments because postoperative cardiac failure is more of a concern in patients with already abnormal cardiac physiology, undergoing significant lung resection. Thoracic surgeons should be challenged by another conundrum to accurately select the best candidates for surgical treatment. Usually perioperative management of antithrombotic therapy in patients who need general thoracic operations such as lung cancer surgery after coronary artery stent placement or valve replacement have made recommendations, and heparinization is needed for patients with atrial fibrillation for prevention of thrombo-embolism. It is sometimes used in clinical practice as bridging therapy during the period of discontinuation of antiplatelet therapy for patients with cardiac complications after several cardiac surgery. As points to be aware of regarding surgical operations, minimal invasive surgery probably should be performed if possible.