| Perioperative cardiac risk stratification and modification in abdominal aortic aneurysm repair. | |
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MedLine Citation:
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PMID: 17017685 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cardiovascular complications are important causes of morbidity and mortality following vascular surgery. Adequate preoperative risk assessment and perioperative management may modify postoperative mortality and morbidity and improve long-term prognosis. The objective of this review is to examine the present day knowledge regarding the preoperative evaluation and perioperative management of patients undergoing noncardiac surgery, focusing specifically on abdominal aortic aneurysm (AAA) repair. Clinical markers combined with ECG and surgical risk assessment can effectively divide patients in a truly low-risk, intermediate and high-risk population. Low-risk patients can probably be operated on without additional cardiac testing. Notably, due to the surgical risk, AAA patients are never low-risk patients. Intermediate-risk and high-risk patients are referred for cardiac testing to exclude extensive stress induced myocardial ischemia, as beta-blockers provide insufficient myocardial protection in this case and preoperative coronary revascularization might be considered. Whether patients at intermediate risk without ischemic heart disease should be treated with statins and/or beta-blockers is still controversial. In high-risk patients, it is strongly advised to administer beta-blockers with heart rate determined dose adjustment, while the effects of preoperative revascularization remain subject to debate. |
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Authors:
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M Dunkelgrun; O Schouten; H H H Feringa; P G Noordzij; S Hoeks; E Boersma; J J Bax; D Poldermans |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Acta chirurgica Belgica Volume: 106 ISSN: 0001-5458 ISO Abbreviation: Acta Chir. Belg. Publication Date: 2006 Jul-Aug |
Date Detail:
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Created Date: 2006-10-04 Completed Date: 2007-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370571 Medline TA: Acta Chir Belg Country: Belgium |
Other Details:
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Languages: eng Pagination: 361-6 Citation Subset: IM |
Affiliation:
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Vascular Surgery, Erasmus Medical Center, Rotterdam, The Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use Aortic Aneurysm, Abdominal / surgery* Biological Markers / analysis Electrocardiography Heart Diseases / prevention & control* Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use Perioperative Care* Postoperative Complications / prevention & control* Risk Assessment Risk Factors |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Biological Markers; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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