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Preanesthetic consultation for cardiac surgery

Author
Atilio Barbeito, MD, MPH
Section Editor
Jonathan B Mark, MD
Deputy Editor
Nancy A Nussmeier, MD, FAHA

INTRODUCTION

Although cardiac surgical techniques and outcomes have improved in the past decade, considerable risks for perioperative morbidity and mortality persist. This topic will review the anesthesiologist's preoperative evaluation of a cardiac surgical patient. This includes assessing cardiac and overall health risks, identifying issues that could cause problems during and after surgery, working with the cardiologist and cardiac surgeon to optimize medical conditions, developing an anesthetic care plan, educating the patient regarding anesthetic care, and alleviating patient anxiety. Intraoperative anesthetic management for cardiac surgical procedures (eg, coronary artery bypass grafting [CABG]) is discussed separately. (See "Anesthesia for coronary artery bypass grafting surgery".)

GOALS OF THE PREANESTHESIA EVALUATION

During the preoperative consultation, the anesthesiologist will:

Review the patient's history, physical examination, and available cardiac and other diagnostic tests to assess risks for the proposed operation, and then develop an anesthetic plan to minimize risks. (See 'Assessment of patient and procedural risk factors' below.)

Discuss opportunities to optimize the patient's preoperative condition with the cardiologist and cardiac surgeon. As a general rule, surgery should be postponed if all of the following criteria are met: the surgery is elective, the patient's medical condition can be significantly improved, and the risk of postponing surgery is less than the benefit of optimizing the patient's condition.

Explain the proposed anesthetic plan to the patient and obtain informed consent for anesthetic care. Answer all questions related to perioperative anesthetic care.

                                    

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Literature review current through: Nov 2016. | This topic last updated: Wed Nov 23 00:00:00 GMT 2016.
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