Präoperatives Vorgehen bei elektiven, nicht-kardiochirurgischen Eingriffen – Erweiterte Maßnahmen bei kardialen Risikopatienten

Abstract

Preoperative differentiated cardiac clarification may be necessary in case of patients suffering from known or suspected cardiovascular diseases. Such clarification should be effected well before surgery. This preparatory investigation should include pharmacological and interventional aspects as well as any necessary examinations or re-programming of therapeutic implants such as pacemakers or implantable cardiovert defibrillators (ICD) or if necessary co-ordination. Decision for or against extended preoperative diagnosis depends on four factors: presence of an acute symptomatic cardiac disease, presence of cardiac risk factors in the patient, the patient's capacity to cope with stress factors and the cardiac risk of surgery. By means of transparent and definite interdisciplinary agreement it should be possible to arrive at a mutual consent on the situation of cardiac risk patients while avoiding unnecessary preoperative examinations. This shortens preoperative procedures and finally also cuts down the overall cost.