Behandlung von Patienten und Patientinnen mit chronischer Herzinsuffizienz in der perioperativen Phase einer herzchirurgischen Operation

Heart failure is one of the most common causes of premature death in industrialized nations. The treatment of patients with chronic heart failure in the perioperative phase of cardiac surgery is therefore highly relevant in the field of cardiac surgery.

The topics of this article are the preoperative optimization of modifiable risk factors, perioperative and intensive care treatment options and postoperative outpatient care.

Analysis and review of current studies and guidelines on patients with heart failure in cardiac surgery were included.

The perioperative risk of patients with heart failure can be reduced by guideline-conform drug treatment of heart failure and preoperative optimization of existing controllable risk factors. In an interdisciplinary heart team, individualized treatment should be discussed for each patient with heart failure before cardiac surgery. Intensive care treatment should aim to optimize cardiac function and can include temporary mechanical circulatory support. Continued outpatient care in the sense of a close connection to specialized centers is an important pillar of care for this patient collective.

By treating patients with heart failure in specialized centers and providing interdisciplinary care and individualized selection of treatment options, the perioperative risk of these patients can be reduced.