Our Summary

This paper reviews recent research on congestive heart failure (CHF), a common disease in the elderly that can greatly increase the risk of death during and after surgery. Recent studies have shown that patients who have a low heart ejection fraction (a measure of the heart’s pumping ability) are at a particularly high risk. The paper also discusses new guidelines for assessing and preparing patients with CHF for surgery. It emphasizes the importance of tests like the brain natriuretic peptide test for predicting patient outcomes. The paper also discusses treatments for those with low cardiac output, but cautions that these treatments should only be used selectively. Overall, the paper highlights the need for more research into CHF and its impact on surgical outcomes.

FAQs

  1. How does congestive heart failure (CHF) increase the risk of death during and after surgery?
  2. What are the new guidelines for preparing patients with CHF for surgery?
  3. What is the brain natriuretic peptide test and how does it help in predicting patient outcomes?

Doctor’s Tip

A helpful tip a doctor might tell a patient about brain surgery is to follow all pre-operative instructions carefully, including fasting guidelines and medication instructions. It is important to discuss any concerns or questions with your healthcare team before the surgery. Additionally, post-operative care and rehabilitation are crucial for a successful recovery, so be sure to follow all post-operative instructions and attend follow-up appointments as scheduled. It is also important to prioritize rest and allow your body time to heal following the surgery.

Suitable For

Patients who are typically recommended for brain surgery are those who have conditions such as tumors, aneurysms, epilepsy, Parkinson’s disease, or traumatic brain injuries that cannot be effectively treated with medication or other non-invasive treatments. Other factors that may warrant brain surgery include progressive neurological deficits, severe headaches, seizures that are not controlled with medication, and abnormal brain scans showing structural abnormalities. The decision to recommend brain surgery is usually made by a team of specialists, including neurosurgeons, neurologists, and other healthcare providers, who carefully assess the patient’s overall health, medical history, and the risks and benefits of the surgery.

Timeline

Before brain surgery:

  1. Patient is diagnosed with a condition that requires brain surgery, such as a tumor or aneurysm.
  2. Patient undergoes pre-operative evaluations, including imaging tests and blood work.
  3. Patient meets with their surgical team to discuss the procedure, risks, and potential outcomes.
  4. Patient may undergo additional tests or treatments to optimize their health before surgery.

After brain surgery:

  1. Patient is closely monitored in the intensive care unit immediately after surgery.
  2. Patient may experience side effects such as headache, nausea, or fatigue.
  3. Patient undergoes post-operative evaluations to assess their recovery and monitor for any complications.
  4. Patient may require rehabilitation or physical therapy to regain function and mobility.
  5. Patient follows a follow-up plan with their surgical team to ensure proper healing and long-term recovery.

What to Ask Your Doctor

  1. What specific type of brain surgery do you recommend for my condition?
  2. What are the potential risks and complications associated with this type of surgery?
  3. How experienced are you in performing this type of surgery?
  4. What is the expected recovery time and rehabilitation process after the surgery?
  5. Will I require any additional treatments or medications post-surgery?
  6. How will you monitor and manage my congestive heart failure during and after the surgery?
  7. Are there any specific precautions or lifestyle changes I need to make before the surgery?
  8. What is the success rate of this surgery for patients with congestive heart failure?
  9. Are there any alternative treatment options available for my condition?
  10. What steps will be taken to ensure my safety and well-being during the surgery and recovery process?

Reference

Authors: Smit-Fun V, Buhre WF. Journal: Curr Opin Anaesthesiol. 2016 Jun;29(3):391-6. doi: 10.1097/ACO.0000000000000335. PMID: 26978592