Perioperative Assessment and Management of Patients with Heart Failure

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Mena Gewarges
Claudia Frankfurter
Michael McDonald


heart failure, elderly, coronary artery disease, preoperative evaluation


In noncardiac surgery, a preexisting diagnosis of heart failure (HF) serves as a significant risk factor for major adverse cardiac events. Among elderly patients, this risk is heightened, where the risk of operative mortality and hospital readmission for the same operative procedure has been found to be greater in HF patients than it is for patients with coronary artery disease. In this review, we summarize the requisite preoperative evaluation and management of HF patients undergoing noncardiac surgery and highlight the important perioperative monitoring and management considerations.

En chirurgie non cardiaque, un diagnostic préexistant d’insuffisance cardiaque constitue un facteur de risque important d’évènements cardiaques indésirables majeurs. Chez les patients âgés, ce risque est accru, car on constate que le risque de mortalité opératoire et de réadmission à l’hôpital pour la même intervention chirurgicale est plus élevé chez les patients atteints d’insuffisance cardiaque que chez ceux atteints d’une coronaropathie. Dans cet article de synthèse, nous résumons l’évaluation et la prise en charge préopératoires requises pour les patients atteints d’insuffisance cardiaque qui subissent une intervention chirurgicale non cardiaque et nous soulignons les aspects importants de la surveillance et de la prise en charge périopératoires.

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