Perioperative dental screening and treatment in patients undergoing cardio-thoracic surgery and interventional cardiovascular procedures. A consensus report based on RAND/UCLA methodology.

Autor: Cotti E; Department of Conservative Dentistry and Endodontics, University of Cagliari, Italy. Electronic address: cottiendo@gmail.com., Cairo F; Research Unit in Periodontology and Periodontal Medicine, University of Florence, Italy., Bassareo PP; University College of Dublin, Mater Misericordiae University Teaching Hospital, Dublin, Ireland., Fonzar F; Private practice, Udine, Italy., Venturi M; Private practice, Bologna, Italy., Landi L; Private practice, Verona, Roma, Italy., Parolari A; Unit of Cardiac Surgery and Translational Researh, IRCCS Policlinico S. Donato, San Donato, Italy., Franco V; Private practice, Roma, Italy., Fabiani C; Private practice, Roma, Italy., Barili F; Department of Cardiac Surgery, S. Croce Hospital, Cuneo, Italy., Di Lenarda A; Cardiovascular Center ASS1, Trieste, Italy., Gulizia M; Division of Cardiology, Hospital 'Garibaldi-Nesima', Catania, Italy., Borzi M; Department of Cardiovascular Disease, University of Rome Tor Vergata, Rome, Italy., Campus G; Department of Surgery, Microsurgery and Medicine Sciences, University of Sassari, Italy., Musumeci F; Department of Heart and Vessels, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Roma, Italy., Mercuro G; Department of Medical Sciences, Cagliari, Italy.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2019 Oct 01; Vol. 292, pp. 78-86. Date of Electronic Publication: 2019 Jun 17.
DOI: 10.1016/j.ijcard.2019.06.041
Abstrakt: Aim: To reach a consensus on a consistent strategy to adopt when screening patients for dental/periodontal infections, and on the feasibility of providing dental treatment before cardiothoracic surgery, cardiovascular surgery or other cardiovascular invasive procedures.
Methodology: A panel of experts from six Italian scientific societies was created. The deliberations of the panel were based on the RAND method. From an initial systematic literature review, it became clear that a consensually validated protocol for the reproducible dental screening of patients awaiting cardiac interventions was considered mandatory by professionals with expertise in the dental, cardiologic and cardiac surgery areas. However, systematic review also concluded that the treatment options to be provided, their prognosis and timing in relation to the physical condition of patients had never been defined. Following the systematic review several fundamental questions were generated. The panel was divided into two working groups each of which produced documents that addressed the topic and which were subsequently used to generate a questionnaire. Each member of the panel completed the questionnaire independently and then a panel discussion was held to reach a consensus on how best to manage patients with dental/periodontal infections who were awaiting invasive cardiac procedures.
Results: A high level of agreement was reached regarding all the items on the questionnaire, and each of the clinical questions formulated were answered. Three tables were created which can be used to generate a useful tool to provide standardized dental/periodontal screening of patients undergoing elective cardiovascular interventions, and to summarize both the possible oral and cardiovascular conditions of the patient and the timing available for the procedures considered.
Conclusions: Upon publication of this consensus document, the dissemination of the information to a wide dental and cardiac audience should commence. The authors hope that this consensus can become a model for the development of a dedicated protocol, ideally usable by heart and dental teams in the pre-interventional preparation phase.
(Copyright © 2019 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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