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. Perioperative myocardial injury (PMI) is increasingly recognised as an important complication of non-cardiac surgery, with often clinically silent presentation, but detrimental prognosis. Active screening for PMI, involving the detection of dynamic and elevated levels of cardiac troponin, has recently been advocated by an increasing number of guidelines; however, active PMI screening has not been reflected in clinical practice. . As consensus on a common screening and management pathway is lacking, we synthesise the current evidence to provide suggestions on the selection of patients for screening, organisation of a screening program, and a potential management pathway, building upon a recently published perioperative screening algorithm. . Screening should be performed using high-sensitivity assays both preoperatively and postoperatively (postoperative Days 1 and 2) in patients at high-risk of experiencing perioperative complications. . This expert opinion piece by an interdisciplinary group of predominantly Norwegian clinicians aims to assist healthcare professionals planning to implement guideline-recommended PMI screening at a local level in order to improve patient outcomes following non-cardiac surgery.
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http://dx.doi.org/10.1080/14017431.2022.2112071 | DOI Listing |
Front Med (Lausanne)
August 2025
Department of Anesthesiology, Zhuhai City People's Hospital, The Affiliated Hospital of Beijing Institute of Technology, Zhuhai Clinical Medical College of Jinan University, Zhuhai, Guangdong, China.
Background: Postoperative deep venous thrombosis (DVT) is a critical complication of non-cardiac surgery. Hypoalbuminemia reflects both nutritional depletion and inflammation, which may contribute to DVT pathogenesis. In this study, we evaluated preoperative albumin's association with DVT in patients undergoing elective non-cardiac surgery, and identified risk-stratifying thresholds.
View Article and Find Full Text PDFSurg Case Rep
August 2025
Department of Cardiac and Vascular Surgery, Dokkyo Medical University School of Medicine, Shimotsugagun, Tochigi, Japan.
Introduction: Prosthetic valve endocarditis following aortic root replacement (ARR) typically necessitates redo-ARR, which involves complete graft removal, extensive aortic root dissection, and coronary reimplantation. This highly invasive procedure carries substantial surgical risk, including high operative mortality. In select high-risk patients without evidence of prosthetic graft infection, alternative surgical strategies may reduce procedural complexity and improve outcomes.
View Article and Find Full Text PDFJ Am Geriatr Soc
September 2025
Frailty Research Center, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA.
Background: Prehabilitation may help older adults recover after surgery, yet adherence has been variable. We assessed the feasibility of a multi-component prehabilitation program.
Methods: This single-arm trial was conducted at an academic medical center to test the feasibility of an individualized prehabilitation program before major surgery.
J Obes Metab Syndr
September 2025
Integrated Perioperative Geriatric Excellent Research Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Background: Morbid obesity is a well-established risk factor for cardiovascular disease. Diastolic dysfunction, particularly in non-cardiac surgeries, has been associated with increased incidence of adverse cardiovascular events. This study aimed to evaluate the prevalence of diastolic dysfunction in morbidly obese patients undergoing bariatric surgery and to identify associated clinical risk factors using transesophageal echocardiography (TEE).
View Article and Find Full Text PDFJ Clin Anesth
September 2025
Department of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands; Department of Intensive Care, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands; Department of Epidemiology and Data Science, Amsterdam UM
Background: Many physiological processes show a diurnal rhythm, including sympathetic and parasympathetic tone, adrenal hormone secretion and blood pressure. Since these physiological rhythms may affect the sensitivity to anaesthesia, we hypothesised that the time of day when anaesthesia induction occurs may affect the incidence of post-induction hypotension.
Methods: This was a post-hoc propensity score matched analysis of prospectively collected blood pressure data of 760 elective non-cardiac surgery patients receiving general anaesthesia.