Raghunathan Deepa, Palaskas Nicolas L, Yusuf Syed Wamique, Eagle Kim A
University of Texas Health Science Center at Houston , Texas, USA.
Department of Cardiology, University of Texas MD Anderson Cancer Center , Houston, TX, USA.
Expert Rev Cardiovasc Ther. 2020 May;18(5):249-259. doi: 10.1080/14779072.2020.1757432. Epub 2020 May 14.
About 234 million major surgical procedures are performed each year worldwide, of which >60 million surgeries are performed in the United States. Though postoperative major adverse cardiac complications are relatively low, patients with postoperative myocardial infarction have higher in-hospital mortality. Thus, comprehensive cardiac evaluations, and in some cases, elective coronary revascularizations, are performed prior to surgery with an intent to minimize these complications. In 2009, approximately 4% of all elective percutaneous coronary interventions were performed in preparation for noncardiac surgery.
We discuss relevant articles from the last 50 years regarding elective preoperative coronary revascularization prior to noncardiac surgery.
In the early years there was an interest in preemptive revascularization to reduce postoperative cardiac events; however, subsequent studies in patients with stable coronary artery disease have mostly shown that a strategy of routine prophylactic coronary revascularization prior to noncardiac surgery does not reduce postoperative cardiac complications.
全球每年约进行2.34亿例大型外科手术，其中美国进行的手术超过6000万例。尽管术后严重心脏不良并发症的发生率相对较低，但术后心肌梗死患者的院内死亡率较高。因此，术前会进行全面的心脏评估，在某些情况下还会进行选择性冠状动脉血运重建，以尽量减少这些并发症。2009年，所有选择性经皮冠状动脉介入治疗中约有4%是为非心脏手术做准备。
我们讨论了过去50年中关于非心脏手术前选择性术前冠状动脉血运重建的相关文章。
早期人们对预防性血运重建以减少术后心脏事件很感兴趣；然而，随后对稳定型冠状动脉疾病患者的研究大多表明，非心脏手术前常规预防性冠状动脉血运重建策略并不能降低术后心脏并发症的发生率。
