Details

Autor(en) / Beteiligte

• Fleisher, Lee A., MD, FACC, FAHA
• Beckman, Joshua A., MD, FACC
• Brown, Kenneth A., MD, FACC, FAHA
• Calkins, Hugh, MD, FACC, FAHA
• Chaikof, Elliot L., MD
• Fleischmann, Kirsten E., MD, MPH, FACC
• Freeman, William K., MD, FACC
• Froehlich, James B., MD, MPH, FACC
• Kasper, Edward K., MD, FACC
• Kersten, Judy R., MD, FACC
• Riegel, Barbara, DNSc, RN, FAHA
• Robb, John F., MD, FACC

Titel

2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery

Ist Teil von

• Journal of the American College of Cardiology, 2009-11, Vol.54 (22), p.e13-e118

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2009

Quelle

MEDLINE

Beschreibungen/Notizen

• 2009 Focused Update Writing Group Members Kirsten E. Fleischmann, MD, MPH, FACC, Chair Joshua A. Beckman, MD, FACC**SVM Representative; Christopher E. Buller, MD, FACC[dagger][dagger]ACCF/AHA Task Force on Practice Guidelines Liaison; Hugh Calkins, MD, FACC, FAHA[double dagger] Lee A. Fleisher, MD, FACC, FAHA[double dagger][double dagger]ACCF/AHA Representative William K. Freeman, MD, FACC¶ James B. Froehlich, MD, MPH, FACC[double dagger][double dagger] Edward K. Kasper, MD, FACC, FAHA[double dagger][double dagger] Judy R. Kersten, MD, FACC# John F. Robb, MD, FACC, FAHA|| R. James Valentine, MD§ Task Force Members Alice K. Jacobs, MD, FACC, FAHA, Chair 2009-2011 Sidney C. Smith, Jr, MD, FACC, FAHA, Immediate Past Chair 2006-2008§§Former Task Force member during this writing effort Jeffrey L. Anderson, MD, FACC, FAHA, Vice Chair Christopher E. Buller, MD, FACC Mark A. Creager, MD, FACC, FAHA Steven M. Ettinger, MD, FACC Robert A. Guyton, MD, FACC, FAHA Jonathan L. Halperin, MD, FACC, FAHA Judith S. Hochman, MD, FACC, FAHA Harlan M. Krumholz, MD, FACC, FAHA§§ Frederick G. Kushner, MD, FACC, FAHA Bruce W. Lytle, MD, FACC, FAHA§§ Rick Nishimura, MD, FACC, FAHA§§ Richard L. Page, MD, FACC, FAHA§§ William G. Stevenson, MD, FACC, FAHA Lynn G. Tarkington, RN Clyde W. Yancy, MD, FACC, FAHA Table of Contents Preamble (UPDATED)...e15 Introduction/Definition of the Problem (UPDATED)...e16 Methodology and Evidence Review (UPDATED)...e17 Organization of Committee and Relationships With Industry and Other Entities (NEW)...e17 Document Review and Approval (UPDATED)...e18 Epidemiology...e18 Practice Patterns...e19 Financial Implications...e19 General Approach to the Patient...e19 Role of the Consultant...e19 History...e20 Physical Examination...e20 Comorbid Diseases...e21 Pulmonary Disease...e21 Diabetes Mellitus...e21 Renal Impairment...e22 Hematologic Disorders...e22 Ancillary Studies...e22 Multivariable Indices to Predict Preoperative Cardiac Morbidity...e23 Clinical Assessment...e23 Stepwise Approach to Perioperative Cardiac Assessment...e23 Disease-Specific Approaches...e26 Coronary Artery Disease...e26 Patients With Known CAD...e26 Influence of Age and Gender...e26 Hypertension...e26 Heart Failure...e28 Cardiomyopathy...e28 Valvular Heart Disease...e28 Arrhythmias and Conduction Defects...e29 Implanted Pacemakers and ICDs...e30 Pulmonary Vascular Disease and Congenital Heart Disease...e30 Surgery-Specific Issues...e30 Urgency...e31 Surgical Risk...e31 Supplemental Preoperative Evaluation...e34 Assessment of LV Function...e34 Assessment of Risk for CAD and Assessment of Functional Capacity...e35 The 12-Lead ECG...e35 Exercise Stress Testing for Myocardial Ischemia and Functional Capacity...e35 Noninvasive Stress Testing...e37 Radionuclide Myocardial Perfusion Imaging Methods...e37 Dobutamine Stress Echocardiography...e40 Stress Testing in the Presence of Left Bundle-Branch Block...e42 Ambulatory ECG Monitoring...e43 Recommendations: If a Test Is Indicated, Which Test?...e43 Implications of Guidelines and Other Risk Assessment Strategies for Costs and Outcomes...e44 Perioperative Therapy...e45 Preoperative Coronary Revascularization With CABG or Percutaneous Coronary Intervention...e45 Rationale for Surgical Coronary Revascularization...e45 Preoperative CABG...e46 Preoperative PCI...e48 PCI Without Stents: Coronary Balloon Angioplasty...e50 PCI: DES...e52 Stent Thrombosis and DES...e53 Perioperative Management of Patients With Prior PCI Undergoing Noncardiac Surgery...e56 Perioperative Management in Patients Who Have Received Intracoronary Brachytherapy...e57 Risks Associated With Perioperative Antiplatelet Agents...e57 Strategy of Percutaneous Revascularization in Patients Needing Urgent Noncardiac Surgery...e58 Perioperative Medical Therapy (UPDATED)...e59 Recommendations for Perioperative Beta-Blocker Therapy (UPDATED)...e59 Evidence on Efficacy of Beta-Blocker Therapy (UPDATED)...e61 Recent Data Regarding Perioperative Beta-Blocker Therapy (NEW)...e64 Titration of Beta Blockers (UPDATED)...e66 Withdrawal of Beta Blockers (UPDATED)...e67 Risks and Caveats (NEW)...e67 Summary (NEW)...e68 Perioperative Statin Therapy...e68 Alpha-2 Agonists...e70 Perioperative Calcium Channel Blockers...e70 Prophylactic Valvular Intervention Before Noncardiac Surgery...e71 Perioperative Arrhythmias and Conduction Disturbances...e71 Intraoperative Electromagnetic Interference With Implanted Pacemakers and ICDs...e72 Preoperative Intensive Care...e73 Venothromboembolism/Peripheral Arterial Disease...e73 Anesthetic Considerations and Intraoperative Management...e74 Choice of Anesthetic Technique and Agent...e74 Perioperative Pain Management...e76 Prophylactic Intraoperative Nitroglycerin...e76 Use of TEE...e77 Maintenance of Body Temperature...e77 Intra-Aortic Balloon Counterpulsation Device...e77 Perioperative Control of Blood Glucose Concentration...e78 Perioperative Surveillance...e78 Intraoperative and Postoperative Use of PACs...e80 Intraoperative and Postoperative Use of ST-Segment Monitoring...e80 Surveillance for Perioperative MI...e81 Postoperative Arrhythmias and Conduction Disorders...e83 Postoperative and Long-Term Management...e84 MI: