Nathaen Weitzel
Keynote: Surgery Curr Res
Both the 2007 ACC / AHA guidelines for management of patients for non cardiac surgery, as well as the 2009 European Society of Cardiology perioperative guidelines address the issue of coronary stenting in the perioperative period, yet this remains a significant clinical problem often minimized by clinicians. Despite existing reports of stent thrombosis with drug eluting stents, newer drug eluting stent agents may provide better outcomes both for restenosis and thrombosis, highlighting the importance of a full understanding of these type of stents. Debate remains as to whether bare metal stents vs DES are better overall, but certain criteria must be considered for these patients in the perioperative period. Newer stents using Everolimus are producing more promising results and there are some early results out using bioabsorbable stents. New data is available from subgroup analysis of the CARP trial as well as the Spirit trials, that changes the bare metal stent v/s DES debate significantly and must be considered in patient evaluation. Bioabsorbable stents are making headlines as well with results from recent trials demonstrating efficacy. Considerations must be made in the perioperative period to account for proper antiplatelet medications and bleeding risk management to balance the thrombotic risk and a case based discussion will highlight the general approach.
Nathaen Weitzel is a cardiothoracic anesthesiologist and currently Associate Professor of Anesthesiology at the University of Colorado, where he serves as Director of TEE services as well as an Assistant Operating Room Director for the hospital. He was the Cardiac Section Editor for the Manual of Clinical Anesthesiology published in 2012, and is the Editor in Chief for Seminars in Cardiothoracic and Vascular Anesthesia since 2011. He has authored 20 book chapters, editorials and peer-reviewed publications with a research focus in cardiothoracic anesthesia, platelet function, and 3D TEE.
