Clinical and Pathological Analysis of Sudden Death after Planned Surgery
| Autor: | A. V. Samorodov, A. L. Urakov, K. N. Zolotukhin, R. R. Dashkin, N. G. Ismagilov, A. I. Abubakirova, Z. R. Pakhomova, Z. R. Mukhametshina |
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| Jazyk: | English<br />Russian |
| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | Креативная хирургия и онкология, Vol 10, Iss 2, Pp 154-161 (2020) |
| Druh dokumentu: | article |
| ISSN: | 2307-0501 2076-3093 |
| DOI: | 10.24060/2076-3093-2020-10-2-154-161 |
| Popis: | Introduction. The growth of oncological morbidity and the advent of novel surgery methods to improve quality of life and longevity entail a steady growth of noncardiac surgery in elderly patients. Provided the general aging of the population, an increase in the number of comorbid patients and a growing use of medical implanted devices, the assessment of main risk factors for perioperative complications acquires a higher relevance.Materials and methods. On the basis of a clinical case of an elderly patient, approaches to perioperative risk assessment; methods for risk factor isolation during the preoperative stage; and the importance of informing the patient about the incurred risk are discussed.Results and discussion. A postmortem examination established stage IV coronary atherosclerosis of 3rd degree, stenosis of left and right coronary artery lumen to 60–80%, atherosclerotic plaque wall raptures in the left coronary artery with haemorrhage into the base (“unstable plaque”), ischemic myocardial dystrophy, pockets of abnormal myocardial blood flow. Th e conducted analysis of the clinical case, along with a review of existing literature sources and American and European guidelines for cardiac risk assessment in non-surgical patients, demonstrates the need for updating domestic recommendations on perioperative risk assessment. Such a revision should complement the current international experience with the meta-analysis of the prognostic value of stress tests, routine coronary angiography and preventive pre-surgical coronary recanalisation.Conclusion. It can be concluded that the existing clinical recommendations and risk assessment scales fail to provide immediate solutions to ensure sufficient patient’s safety in the operating room; rather, these documents should only be considered as a vector for decision making in particular clinical circumstances. |
| Databáze: | Directory of Open Access Journals |
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