Preoperative Cardiac Evaluation with Transthoracic Echocardiography Before Non-cardiac Surgery

Overview

Journal Korean J Anesthesiol

Specialty Anesthesiology

Date 2017 Aug 11

PMID 28794833

Citations 12

Authors

Chi Young Shim

Affiliations

Soon will be listed here.

Abstract

Transthoracic echocardiography has become increasingly popular in clinical practice. It is used for the functional evaluation of patients with various cardiovascular diseases. Its use has been extended further in routine screening for cardiovascular health and in preoperative risk assessment before non-cardiac surgery because it is non-invasive, easy to perform, reproducible, and cost-effective. When the results of preoperative echocardiography contain abnormalities, the findings must be interpreted to determine clinical relevance. However, when the results of preoperative echocardiography are apparently normal, many physicians and surgeons readily think that the patient will not have any cardiovascular events in the future, or at least in the perioperative period. In this review, we will cover 1) current guidelines for preoperative echocardiographic assessment, 2) specific cardiac conditions for which the non-cardiac surgery should be delayed, 3) commonly encountered echocardiographic findings before non-cardiac surgeries, 4) application of stress echocardiography, and 5) clinical perspectives of focused transthoracic echocardiography before non-cardiac surgery.

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References

Wang C, Qu G, Xu H . The short- and long-term outcomes of laparoscopic versus open surgery for colorectal cancer: a meta-analysis. Int J Colorectal Dis. 2014; 29(3):309-20. DOI: 10.1007/s00384-013-1827-1. View

WIKLUND R, STEIN H, Rosenbaum S . Activities of daily living and cardiovascular complications following elective, noncardiac surgery. Yale J Biol Med. 2001; 74(2):75-87. PMC: 2588693. View

Canty D, Royse C, Kilpatrick D, Williams D, Royse A . The impact of pre-operative focused transthoracic echocardiography in emergency non-cardiac surgery patients with known or risk of cardiac disease. Anaesthesia. 2012; 67(7):714-20. DOI: 10.1111/j.1365-2044.2012.07118.x. View

Agarwal S, Rajamanickam A, Bajaj N, Griffin B, Catacutan T, Svensson L . Impact of aortic stenosis on postoperative outcomes after noncardiac surgeries. Circ Cardiovasc Qual Outcomes. 2013; 6(2):193-200. DOI: 10.1161/CIRCOUTCOMES.111.000091. View

Sicari R, Nihoyannopoulos P, Evangelista A, Kasprzak J, Lancellotti P, Poldermans D . Stress Echocardiography Expert Consensus Statement--Executive Summary: European Association of Echocardiography (EAE) (a registered branch of the ESC). Eur Heart J. 2008; 30(3):278-89. DOI: 10.1093/eurheartj/ehn492. View

Polanczyk C, Marcantonio E, Goldman L, Rohde L, Orav J, Mangione C . Impact of age on perioperative complications and length of stay in patients undergoing noncardiac surgery. Ann Intern Med. 2001; 134(8):637-43. DOI: 10.7326/0003-4819-134-8-200104170-00008. View

Rosenmuller M, Thoren Ornberg M, Myrnas T, Lundberg O, Nilsson E, Haapamaki M . Expertise-based randomized clinical trial of laparoscopic versus small-incision open cholecystectomy. Br J Surg. 2013; 100(7):886-94. DOI: 10.1002/bjs.9133. View

Smith C, Leon M, Mack M, Miller D, Moses J, Svensson L . Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011; 364(23):2187-98. DOI: 10.1056/NEJMoa1103510. View

Douglas P, Garcia M, Haines D, Lai W, Manning W, Patel A . ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart.... J Am Soc Echocardiogr. 2011; 24(3):229-67. DOI: 10.1016/j.echo.2010.12.008. View

10.

Kertai M, Boersma E, Bax J, Heijenbrok-Kal M, Hunink M, Ltalien G . A meta-analysis comparing the prognostic accuracy of six diagnostic tests for predicting perioperative cardiac risk in patients undergoing major vascular surgery. Heart. 2003; 89(11):1327-34. PMC: 1767930. DOI: 10.1136/heart.89.11.1327. View

11.

Stather P, Sidloff D, Dattani N, Choke E, Bown M, Sayers R . Authors' reply: systematic review and meta-analysis of the early and late outcomes of open and endovascular repair of abdominal aortic aneurysm (Br J Surg 2013; 100: 863-872). Br J Surg. 2013; 100(10):1397-8. DOI: 10.1002/bjs.9247. View

12.

Fleisher L, Fleischmann K, Auerbach A, Barnason S, Beckman J, Bozkurt B . 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014; 130(24):2215-45. DOI: 10.1161/CIR.0000000000000105. View

13.

Leon M, Smith C, Mack M, Miller D, Moses J, Svensson L . Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010; 363(17):1597-607. DOI: 10.1056/NEJMoa1008232. View

14.

Morris C, Ueshima K, Kawaguchi T, Hideg A, Froelicher V . The prognostic value of exercise capacity: a review of the literature. Am Heart J. 1991; 122(5):1423-31. DOI: 10.1016/0002-8703(91)90586-7. View

15.

Fleisher L . Cardiac risk stratification for noncardiac surgery: update from the American College of Cardiology/American Heart Association 2007 guidelines. Cleve Clin J Med. 2009; 76 Suppl 4:S9-15. DOI: 10.3949/ccjm.76.s4.02. View

16.

Goldman L, Caldera D, Nussbaum S, Southwick F, Krogstad D, Murray B . Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med. 1977; 297(16):845-50. DOI: 10.1056/NEJM197710202971601. View

17.

Kristensen S, Knuuti J, Saraste A, Anker S, Botker H, De Hert S . 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of.... Eur Heart J. 2014; 35(35):2383-431. DOI: 10.1093/eurheartj/ehu282. View

18.

Nishimura R, Otto C, Bonow R, Carabello B, Erwin 3rd J, Guyton R . 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014; 63(22):e57-185. DOI: 10.1016/j.jacc.2014.02.536. View

19.

Vahanian A, Alfieri O, Andreotti F, Antunes M, Baron-Esquivias G, Baumgartner H . Guidelines on the management of valvular heart disease (version 2012). Eur Heart J. 2012; 33(19):2451-96. DOI: 10.1093/eurheartj/ehs109. View

20.

Beattie W, Abdelnaem E, Wijeysundera D, Buckley D . A meta-analytic comparison of preoperative stress echocardiography and nuclear scintigraphy imaging. Anesth Analg. 2005; 102(1):8-16. DOI: 10.1213/01.ane.0000189614.98906.43. View