Letter to the Editor

Perioperative Cardiac Evaluation: The Importance of Cardiac Failure Management

Authors: Haridimos Markogiannakis, MD, Athina Kapralou, MD, Levon Toufektzian, MD, Dimitrios Theodorou, MD, PhD, Stilianos Katsaragakis, MD, PhD

Abstract

To the Editor:


With great interest, we read the excellent review article by Mercado et al,1 which provided a thorough overview of perioperative cardiac evaluation and postoperative cardiac complication risk reduction strategies. We agree with the authors1,2 that cardiac complications are a major cause of perioperative morbidity and mortality after noncardiac surgery. In this review, the pathophysiology, preoperative risk assessment, recent advances, and current challenges in the management of perioperative myocardial ischemia are discussed. Cardiac failure (CF), though, is another major issue regarding postoperative cardiac complications in patients undergoing noncardiac surgery that may also be addressed.

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References

1. Mercado DL, Ling DY, Smetana GW. Perioperative cardiac evaluation: novel interventions and clinical challenges. South Med J 2007;100:486–492.
 
2. Toufektzian L, Theodorou D, Larentzakis A, et al. Optimization of cardiac performance in chronic heart failure patients undergoing elective non-cardiac surgery. Curr Anaesth Crit Care 2007;18:50–57.
 
3. Gelow JM, Fang JC. Update in the approach to and management of heart failure. South Med J 2006;99:1346–1355.
 
4. Hernandez AF, Whellan DJ, Stroud S, et al. Outcomes in heart failure patients after major noncardiac surgery. J Am Coll Cardiol 2004;44:1446–1453.
 
5. Moiseyev VS, Poder P, Andrejevs N, et al. Safety and efficacy of a novel calcium sensitizer, levosimendan, in patients with left ventricular failure due to an acute myocardial infarction. A randomized, placebo-controlled, double-blind study (RUSSLAN). Eur Heart J 2002;23:1422–1432.