NON-CARDIAC SURGERY IN CARDIAC PATIENTS: KEY INSIGHTS

Abstract

The growing elderly population leads to a higher proportion of primarily non-cardiac surgeries being performed on patients with cardiac conditions. This highlights the necessity to review and update protocols for ensuring safe surgery in the patient group mentioned above. The cardiovascular complications are especially prevalent in patients with documented or asymptomatic coronary heart disease, left ventricular (LV) dysfunction, valvular heart disease (VHD) and arrhythmias, particularly when undergoing surgeries that place prolonged strain on the heart and hemodynamics. Preoperative N-terminal fragment of proBNP (NT-proBNP) measurement is the stronger predictor for postoperative complications. We should not initiate beta blockers, alpha-2 agonists, calcium channel blockers and statins, but rather continue them during the preoperative period. The risk of postoperative bleeding should not be the main reason for delaying non-cardiac surgery.