Heart failure: A well-known public health problem, now a major perioperative problem too!

摘要

Heart failure is a well-recognized public health problem with approximately 500,000 new patients diagnosed every year. Despite many new advances in medical treatment, mortality remains high. When heart failure symptoms become refractory to optimal medical therapy, patients are referred for electrophysiological or surgical interventions. Various surgical procedures are being explored to improve the cardiac function, morbidity, and mortality of heart failure patients. Anesthesiologists nowadays encounter these patients more often than before for a wide variety of cardiac interventional and surgical procedures, such as coronary revascularization, mitral valve repair or replacement, aortic valve replacement, ventricular aneurysmectomy, and surgical ventricular restoration. In patients with end-stage heart failure, mechanical circulatory support and heart transplantations are the 2 options. As survival for heart failure patients improves, they are more likely to present for noncardiac surgery as well. These patients require a thorough preoperative evaluation, intensive intraoperative monitoring, and expert postoperative care. This volume of International Anesthesiology Clinics is devoted to the perioperative care of heart failure patients, as we recognize this to be a growing perioperative problem.