Anesthesia for Patients with Peripheral Vascular Disease and Cardiac Dysfunction.
Patients with vascular disease and cardiac dysfunction present particular challenges to the anesthesiologist. They are hemodynamically brittle, at high risk of morbidity and mortality during surgery, and often carry additional comorbidities that increase their complexity and risk. Those with peripheral vascular disease should be assumed to have coronary artery disease and tend to have other systemic vascular problems. Poor cardiac function further worsens perfusion in an already compromised peripheral vascular system. Care of these patients requires judicious monitoring, an anesthetic that optimizes hemodynamic function, and avoidance of particularly likely complications such as perioperative myocardial ischemia, stroke, and bleeding.
Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA. Electronic address: saraeneves@gmail.com.
Sara E
SE
Neves
D054058:Acute Coronary Syndrome / Q000150:complications; D000758:Anesthesia / Q000379:methods*; D002406:Catheterization, Peripheral; D006331:Heart Diseases / Q000150:complications* / Q000628:therapy; D006333:Heart Failure / Q000150:complications; D006349:Heart Valve Diseases / Q000150:complications; D006801:Humans; D017202:Myocardial Ischemia / Q000150:complications; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000628:therapy
Cardiac dysfunction; Coronary artery disease; Perioperative ischemia; Peripheral arterial disease; Vascular disease