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Gepubliceerd in:

2008 | OriginalPaper | Hoofdstuk

52 Hart en niet-cardiale chirurgie

Auteur : Prof.Dr. D. Poldermans

Gepubliceerd in: Cardiologie

Uitgeverij: Bohn Stafleu van Loghum

Samenvatting

Cardiale complicaties zijn de belangrijkste oorzaak van perioperatieve morbiditeit en mortaliteit. In Nederland worden jaarlijks 1,5 miljoen operaties verricht, waarbij in de perioperatieve periode 15.000 (1%) patiënten overlijden, van wie ongeveer 3000 (0,3%) aan cardiovasculaire complicaties. De incidentie van perioperatieve cardiale complicaties is vergelijkbaar met die in de Verenigde Staten van Amerika, waar jaarlijks 26 miljoen ingrepen worden verricht en 78.000 (0,3%) fatale cardiovasculaire complicaties optreden. In de eerste dertig dagen na de operatie kan het risico op cardiale dood, myocardinfarct of hartfalen oplopen tot 10%, afhankelijk van het type operatie en de aanwezigheid van onderliggend coronairlijden. Het is van belang bij de preoperatieve cardiale beoordeling de langetermijnprognose van de onderliggende comorbiditeit, zoals linkerventrikelfunctie, coronairlijden en kleplijden, in de beoordeling mee te nemen. Zo bedraagt de mortaliteit van patiënten die succesvol geopereerd zijn wegens claudicatio intermittens in de eerste drie jaar na de operatie 30-40%. Dit berust op het frequent voorkomen van onderliggend coronairlijden, oplopend tot 70%, waarbij de langetermijnoverleving was gecorreleerd aan de aanwezigheid en de ernst van coronairlijden. Deze patiënten zijn vaak asymptomatisch vanwege een gebrekkig inspanningsvermogen, maar de klachten kunnen na de geslaagde operatie manifest worden. De arts die patiënten vóór een operatie onderzoekt, heeft derhalve een belangrijke taak om het cardiale risicoprofiel in kaart te brengen en eventueel in positieve zin te beïnvloeden, niet alleen om de perioperatieve prognose maar ook de prognose op lange termijn te verbeteren.

vorige hoofdstuk 51 Hartziekten en revalidatie

volgende hoofdstuk 53 Moleculaire cardiologie

Boersma E, Kertai MD, Schouten O, et al. Perioperative cardiovascular mortality in noncardiac surgery: validation of the Lee cardiac risk index. Am J Med. 2005;118:1134–41.PubMedCrossRef

Eagle KA, Berger PB, Calkins H, et al. ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery – executive summary a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Circulation. 2002;105:1257–67.PubMedCrossRef

Eagle KA, Coley CM, Newell JB, et al. Combining clinical and thallium data optimizes preoperative assessment of cardiac risk before major vascular surgery. Ann Intern Med. 1989;110:859–66.PubMedCrossRef

Eagle KA, Rihal CS, Mickel MC, Holmes DR, Foster ED, Gersh BJ. Cardiac risk of noncardiac surgery: influence of coronary disease and type of surgery in 3368 operations. CASS Investigators and University of Michigan Heart Care Program. Coronary Artery Surgery Study. Circulation. 1997;96:1882–7.

Fleisher LA, Beckman JA, Brown KA, et al. ACC/AHA 2006 guideline update on perioperative cardiovascular evaluation for noncardiac surgery: focused update on perioperative beta-blocker therapy: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery): developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society for Vascular Medicine and Biology. Circulation. 2006;113:2662–74.PubMedCrossRef

Grayburn PA, Hillis LD. Cardiac events in patients undergoing noncardiac surgery: shifting the paradigm from noninvasive risk stratification to therapy. Ann Intern Med. 2003;138:506–11.PubMedCrossRef

Kaluza GL, Joseph J, Lee JR, Raizner ME, Raizner AE. Catastrophic outcomes of noncardiac surgery soon after coronary stenting. J Am Coll Cardiol. 2000;35:1288–94.PubMedCrossRef

Kertai MD, Boersma E, Bax JJ, et al. A meta-analysis comparing the prognostic accuracy of six diagnostic tests for predicting perioperative cardiac risk in patients undergoing major vascular surgery. Heart. 2003;89:1327–34.PubMedCentralPubMedCrossRef

Kertai MD, Boersma E, Westerhout CM, et al. A combination of statins and beta-blockers is independently associated with a reduction in the incidence of perioperative mortality and nonfatal myocardial infarction in patients undergoing abdominal aortic aneurysm surgery. Eur J Vasc Endovasc Surg. 2004;28:343–52.PubMedCrossRef

Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999;100:1043–9.PubMedCrossRef

Lindenauer PK, Pekow P, Wang K, Gutierrez B, Benjamin EM. Lipid-lowering therapy and in-hospital mortality following major noncardiac surgery. JAMA. 2004;291:2092–9.PubMedCrossRef

Lindenauer PK, Pekow P, Wang K, Mamidi DK, Gutierrez B, Benjamin EM. Perioperative beta-blocker therapy and mortality after major noncardiac surgery. N Engl J Med. 2005;353:349–61.PubMedCrossRef

Mangano DT, Layug EL, Wallace A, Tateo I. Effect of atenolol on mortality and cardiovascular morbidity after noncardiac surgery. Multicenter Study of Perioperative Ischemia Research Group. N Engl J Med. 1996;335:1713–20.PubMedCrossRef

McFalls EO, Ward HB, Moritz TE, et al. Coronary-artery revascularization before elective major vascular surgery. N Engl J Med. 2004;351:2795–804.PubMedCrossRef

Noordzij PG, Boersma E, Bax JJ, et al. Prognostic value of routine preoperative electrocardiography in patients undergoing noncardiac surgery. Am J Cardiol. 2006;97:1103–6.PubMedCrossRef

O’Neil-Callahan K, Katsimaglis G, Tepper MR, et al. Statins decrease perioperative cardiac complications in patients undergoing noncardiac vascular surgery: the Statins for Risk Reduction in Surgery (StaRRS) Study. J Am Coll Cardiol. 2005;45:336–42.PubMedCrossRef

Pasternak RC, Smith SC Jr, Bairey-Merz CN, Grundy SM, Cleeman JI, Lenfant C. ACC/AHA/NHLBI clinical advisory on the use and safety of statins. J Am Coll Cardiol. 2002;40:567–72.PubMedCrossRef

Poldermans D, Bax JJ, Kertai MD, et al. Statins are associated with a reduced incidence of perioperative mortality in patients undergoing major noncardiac vascular surgery. Circulation. 2003;107:1848–51.PubMedCrossRef

Poldermans D, Boersma E, Bax JJ, et al. The effect of bisoprolol on perioperative mortality and myocardial infarction in highrisk patients undergoing vascular surgery. Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography Study Group. N Engl J Med. 1999;341:1789–94.PubMedCrossRef

Poldermans D, Boersma E, Bax JJ, et al. Correlation of location of acute myocardial infarct after noncardiac vascular surgery with preoperative dobutamine echocardiographic findings. Am J Cardiol. 2001;88:1413–4, A6.

Poldermans D, Fioretti PM, Forster T, et al. Dobutamine stress echocardiography for assessment of perioperative cardiac risk in patients undergoing major vascular surgery. Circulation. 1993;87:1506–12.PubMedCrossRef

Poldermans D, Fioretti PM, Forster T, et al. Dobutamine-atropine stress echocardiography for assessment of perioperative and late cardiac risk in patients undergoing major vascular surgery. Eur J Vasc Surg. 1994;8:286–93.PubMedCrossRef

Practice advisory for the perioperative management of patients with cardiac rhythm management devices: pacemakers and implantable cardioverter-defibrillators. A report by the American Society of Anesthesiologists Task Force on perioperative management of patients with cardiac rhythm management devices. Anesthesiology. 2005;103:186–98.

Raby KE, Brull SJ, Timimi F, et al. The effect of heart rate control on myocardial ischemia among high-risk patients after vascular surgery. Anesth Analg. 1999;88:477–82.PubMed

Rose EL, Liu XJ, Henley M, Lewis JD, Raftery EB, Lahiri A. Prognostic value of noninvasive cardiac tests in the assessment of patients with peripheral vascular disease. Am J Cardiol. 1993;71:40–4.PubMedCrossRef

Schouten O, Kertai MD, Bax JJ, et al. Safety of perioperative statin use in high-risk patients undergoing major vascular surgery. Am J Cardiol. 2005;95:658–60.PubMedCrossRef

Schouten O, Shaw LJ, Boersma E, et al. A meta-analysis of safety and effectiveness of perioperative beta-blocker use for the prevention of cardiac events in different types of noncardiac surgery. Coron Artery Dis. 2006;17:173–9.PubMedCrossRef

Titel: 52 Hart en niet-cardiale chirurgie
Auteur: Prof.Dr. D. Poldermans
Uitgeverij: Bohn Stafleu van Loghum
Boek: Cardiologie
Print ISBN: 978-90-313-4829-9

Elektronisch ISBN: 978-90-313-7029-0

Copyright: 2008
DOI: https://doi.org/10.1007/978-90-313-7029-0_52

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