Lombardi Carlo, Sbolli Marco, Cani Dario, Masini Garbriele, Metra Marco, Faggiano Pompilio
Spedali Civili, University of Brescia.
Monaldi Arch Chest Dis. 2017 Jul 18;87(2):863. doi: 10.4081/monaldi.2017.863.
The preoperative evaluation of patients candidates to noncardiac surgery requires a knowledge of factors related both to type of surgery and to features of the single patient, potentially responsible for perioperative cardiovascular complications , fatal and nonfatal. The assessment of symptoms and/or noninvasive testing indicating the presence of coronary artery disease may suggest the need for medical therapy optimization and, eventually, coronary arteriography before the scheduled timing of noncardiac surgery. There is no evidence favoring a prophylactic myocardial revascularization (percutaneous or surgical) and more studies are needed to define the role of coronary artery disease diagnosis and treatment before high-risk non cardiac surgery.
对拟行非心脏手术患者的术前评估需要了解与手术类型以及单个患者特征相关的因素，这些因素可能导致围手术期心血管并发症，包括致命和非致命性并发症。对提示存在冠状动脉疾病的症状和/或非侵入性检查进行评估，可能表明需要在非心脏手术预定时间之前优化药物治疗，并最终进行冠状动脉造影。没有证据支持预防性心肌血运重建（经皮或手术），需要更多研究来确定高危非心脏手术前冠状动脉疾病诊断和治疗的作用。
