Anesth Analg 2008; 106:751-758
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e31816072b3
CARDIOVASCULAR ANESTHESIOLOGY
Preoperative Coronary Revascularization in High-Risk Patients Undergoing Vascular Surgery: A Core Review
Miklos D. Kertai, MD, PhD*
From the *Department of Cardiothoracic Anaesthesia, Semmelweis University, Budapest, Hungary; and Department of Anesthesia, Harefield Hospital, London, UK.
Address correspondence and reprint requests to Miklos D. Kertai, MD, PhD, Department of Cardiothoracic Anaesthesia, Harefield Hospital, Hill End Road, Harefield, Middlesex, UB9 6JH, UK. Address e-mail to mkertai{at}hotmail.com.
Abstract
Patients undergoing vascular surgery are at increased risk for cardiac complications related to the presence of underlying coronary artery disease. Preoperative cardiac evaluation may help to identify high-risk patients in whom coronary angiography may be planned with subsequent coronary revascularization for the purpose of improving perioperative and long-term cardiac outcomes. However, the indications and efficacy for type of revascularization for the reduction of cardiac complications compared to medical therapy has been controversial. My aim in this review is to summarize the role of preoperative revascularization compared to conservative medical therapy before elective vascular surgery using current evidence from published studies.
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