Preventing Perioperative Cardiovascular Complications: The Conundrum Continues

Perioperative cardiovascular complications or major adverse cardiovascular events (MACEs), including all-cause death, myocardial infarction (MI), cardiac arrest, stroke and repeat revascularization either by PCI or CABG, remain the leading cause of postoperative complications and death among the aged patients (≥ 45 years old) undergoing major noncardiac surgery. Meanwhile, based on the ACC/AHA guidelines on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery, many patients undergo preoperative testing for detection of coronary artery disease (CAD) before noncardiac surgery. However, there are critical clinical choices faced by patients, their caregivers and clinicians, regarding the best preoperative treatment for a patient who has positive results from preoperative cardiac testing: medical treatments versus coronary revascularization, the latter includes PCI and CABG. We are going to talk a fundamental question, perioperative physicians face – how to prepare the patient with significant CAD for major noncardiac surgery or what is the best preoperative treatment for them – a continuing conundrum.

Jianzhong Sun, MD, PhD, completed his clinical residence training in anesthesiology at UPMC at Pittsburgh in early 2000s. Then he joined in Department of Anesthesiology at Thomas Jefferson University and Hospitals as a faculty and Attending Physician. Currently he is Professor and Director of Clinical Outcomes Research in Department of Anesthesiology in this institution. His research involves perioperative medicine, cardiovascular physiology/pharmacology and clinical outcomes. As the burden of perioperative cardiovascular complications continue to rise, the solution is dependent on research, especially large clinical studies and trials, he believes.

The Innovative Discoveries Series, sponsored by the Delaware Clinical & Translational Science ACCEL program and the Christiana Care Value Institute, features informal presentations on topics relevant to current research and healthcare practice, led by knowledgeable and experienced presenters. There are offerings for researchers, healthcare providers, and community members of varying levels of experience.

These free talks are held Fridays at noon at Christiana Hospital but can be viewed from your home or office computer. Earn CMEs by participating in-person or online. Lunch is served and all are welcome to attend.

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  • Jianzhong Sun, MD, PhD