Perioperative anesthetic risk of noncardiac surgery in hypertrophic obstructive cardiomyopathy
R. C. Thompson, R. R. Liberthson and E. Lowenstein
To determine their perioperative risk, we reviewed the records of 35
patients with hypertrophic cardiomyopathy diagnosed by cardiac ultrasound
and/or catheterization who underwent general (52) or spinal (four)
anesthesia--a total of 56 major surgical procedures. There were no
operative or related perioperative deaths and no significant ventricular
tachyarrhythmias. Intraoperative or postoperative complications included:
myocardial infarction with heart failure in one patient who also had
coronary artery disease and was one of three patients who had spinal
anesthesia, arrhythmia requiring therapy in eight, and angina during
supraventricular tachycardia in one. We conclude that the risk of general
anesthesia and major noncardiac surgery is low in patients with
hypertrophic obstructive cardiomyopathy. Spinal anesthesia, which decreases
systemic vascular resistance and increases capacitance, may be relatively
contraindicated. Concomitant coronary artery disease may increase the risk.
ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Developed in Collaboration With the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery
Fleisher et al.
J Am Coll Cardiol 2007;50:e159-e242.
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ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery)
Fleisher et al.
Circulation 2007;116:e418-e500.
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Assessing and Reducing the Cardiac Risk of Noncardiac Surgery
Auerbach and Goldman
Circulation 2006;113:1361-1376.
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Paravertebral somatic nerve blocks for breast surgery in a patient with hypertrophic obstructive cardiomyopathy: [Les blocs paravertebraux des nerfs somatiques pour une intervention mammaire chez une patiente qui presente une cardiomyopathie obstructive]
Buckenmaier et al.
Canadian J. Anesthesia 2002;49:571-574.
ABSTRACT
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ACC/AHA Guideline Update for Perioperative Cardiovascular Evaluation for Noncardiac Surgery--Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery)
Eagle et al.
Circulation 2002;105:1257-1267.
FULL TEXT
ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery--executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery)
Eagle et al.
J Am Coll Cardiol 2002;39:542-553.
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Preoperative Cardiac Preparation
Belzberg and Rivkind
Chest 1999;115:82S-95S.
ABSTRACT
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