There are increasingly more patients who have undergone transcatheter aortic valve replacement (TAVR) and require a non-cardiac intervention, or patients with other diseases who need surgery and are diagnosed with aortic stenosis. In addition, on many occasions, surgery must be performed as soon as possible (as in cases of cancer) or is an emergency procedure.…
ACC 2022 – POISE-3: Tranexamic Acid, Bleeding and Cardiovascular Events in Non-Cardiac Surgeries
Tranexamic Acid is an antifibrinolytic which has been shown to reduce bleeding in orthopedic patients and cardiac surgery. But evidence for its use in non-cardiac surgery is still limited. The aim of this study was to assess whether tranexamic acid reduces the incidence of bleeding events, which include life threatening bleeding, major bleeding, or bleeding…
More Screening Needed Before Non-Cardiac Surgery
According to this recent document by the American Heart Association (AHA), troponin should be monitored for at least 3 days after surgery. With about 20% of patients (most of them, asymptomatic) showing elevated troponin after a non-cardiac surgery, this new AHA document recommends monitoring, for at least two days, patients with moderate to severe ischemia. Myocardial…
How to Discontinue Antiplatelet Therapy Prior Non-Cardiac Surgery
Both the indication and discontinuation of antiplatelet therapy to balance ischemic-bleeding risks has been left to physician criterion. However, leaving the decision to one single specialist might not be the best. This is when the team’s role becomes essential. This study looked at the advantages consensus decision-making amongst clinicians, surgeons and anesthesiologists to continue or…
ACC 2018 | Risk of MI in Non-Cardiac Surgeries
One in five patients presenting perioperative MI during non-cardiac surgery should be readmitted within 30 days after surgery, and one in seven dies within the same period, according to the new study presented at ACC 2018 scientific sessions and simultaneously published in Circulation. These infarctions could be considered a iatrogenic complication, given the obvious lack of proper…