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(Circulation. 2007;116:1971-1996.)
© 2007 American Heart Association, Inc.

ACC/AHA Guideline

ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: Executive Summary

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

WRITING COMMITTEE: Lee A. Fleisher, MD, FACC, FAHA, Chair; Joshua A. Beckman, MD, FACC^¶; Kenneth A. Brown, MD, FACC, FAHA; Hugh Calkins, MD, FACC, FAHA; Elliot L. Chaikof, MD^#; Kirsten E. Fleischmann, MD, MPH, FACC; William K. Freeman, MD, FACC^*; James B. Froehlich, MD, MPH, FACC; Edward K. Kasper, MD, FACC; Judy R. Kersten, MD, FACC; Barbara Riegel, DNSc, RN, FAHA; John F. Robb, MD, FACC^||

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 

Preamble...1972

   I. Definition of the Problem...1973

      A. Purpose of These Guidelines...1973

      B. Methodology and Evidence...1973

   II. General Approach to the Patient...1978

      A. History...1978

      B. Physical Examination and Routine Laboratory Tests...1980

      C. Multivariable Indices to Predict Preoperative Cardiac Morbidity...1980

      D. Clinical Assessment...1980

         1. Stepwise Approach to Perioperative Cardiac Assessment...1980

   III. Disease-Specific Approaches...1982

      A. Coronary Artery Disease...1982

         1. Patients With Known CAD...1982

      B. Hypertension...1982

      C. Valvular Heart Disease...1982

   IV. Surgery-Specific Issues...1983

   V. Supplemental Preoperative Evaluation...1983

      A. Assessment of LV Function...1983

      B. Assessment of Risk for CAD and Assessment of Functional Capacity...1983

         1. The 12-Lead ECG...1983

         2. Exercise Stress Testing for Myocardial Ischemia and Functional Capacity...1983

         3. Noninvasive Stress Testing...1983

   VI. Perioperative Therapy...1983

      A. Preoperative Coronary Revascularization With Coronary Artery Bypass Grafting or PCI...1983

         1. Preoperative Coronary Artery Bypass Grafting...1983

         2. Preoperative PCI ...1984

         3. PCI Without Stents: Coronary Balloon Angioplasty...1984

         4. PCI: Bare-Metal Coronary Stents...1984

         5. PCI: Drug-Eluting Stents...1984

         6. Perioperative Management of Patients With Prior PCI Undergoing Noncardiac Surgery...1985

         7. Perioperative Management in Patients Who Have Received Intracoronary Brachytherapy...1985

         8. Strategy of Percutaneous Revascularization in Patients Needing Urgent Noncardiac Surgery...1985

      B. Perioperative Medical Therapy...1986

         1. Perioperative Beta-Blocker Therapy...1986

            a. Titration of Beta Blockers...1986

            b. Withdrawal of Beta Blockers...1986

         2. Perioperative Statin Therapy...1986

         3. Alpha-2 Agonists...1987

         4. Perioperative Calcium Channel Blockers...1987

      C. Intraoperative Electromagnetic Interference With Implanted Pacemakers and Cardioverter Defibrillators...1987

   VII. Anesthetic Considerations and Intraoperative Management...1987

      A. Intraoperative Management...1987

      B. Perioperative Pain Management...1988

   VIII. Perioperative Surveillance...1988

      A. Intraoperative and Postoperative Use of Pulmonary Artery Catheters...1988

      B. Surveillance for Perioperative MI...1988

   IX. . . . [Full Text of this Article]

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