CCS Perioperative Guidelines

What's new (current)
About this site

The American Journal of Cardiology, The American Journal of Medicine and The Canadian Journal of Cardiology developed the Reducing Global Perioperative Risk Resource Center in collaboration with the Population Health Research institute (PHRI), Canada’s premiere global health research institute and a world leader in large clinical trials and population studies.

Statement of Peer Review

This multimedia publication was reviewed and approved for publication by the editorial offices of The American Journal of Cardiology, The American Journal of Medicine and The Canadian Journal of Cardiology.

Disclaimer Statement

The opinions or views expressed on this publication are those of the authors and do not necessarily reflect the opinions and recommendations of the publisher or supporters. Articles may discuss pharmaceutical products and/or use of products that have not been approved by the US Food and Drug Administration or other regulatory authorities outside the United States. Dosages, indication, and methods of use for compounds that are referred to by the presenters/authors may reflect their clinical experience or may be derived from the professional literature or other sources. For approved product information, consult the manufacturer's prescribing information or the applicable regulatory authority.

Disclosure of Funding

Funding for this site was received from the PHRI through a grant from the Canadian Institutes of Health Research (CIHR).
Faculty Disclosures

Faculty Disclosures

Guest Editors

PJ Devereaux, MD, PhD, FRCPC, is a member of a research group with a policy of not accepting honorariums or other payments from industry for their own personal financial gain. They do accept honorariums/payments from industry to support research endeavors and costs to participate in meetings. Based on study questions Dr. Devereaux has originated and grants he has written, he has received grants from Abbott Diagnostics, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers-Squibb, Coviden, Octapharma, Philips Healthcare, Roche Diagnostics and Stryker. Dr. Devereaux has participated in an advisory board meeting for GlaxoSmithKline and an expert panel meeting with AstraZeneca and Boehringer Ingelheim.

Michael McGillion, RN, PhD, is a member of a research group with a policy of not accepting honorariums or other payments from industry for their own personal financial gain. They do accept honorariums/payments from industry to support research endeavors and costs to participate in meetings. Based on study questions, Dr. McGillion has originated and grants he has written, he has received peer-reviewed grants from government funding agencies which include in-kind support from Philips, QoC Health, and ThoughtWire.

Program Participants

Emmanuelle Duceppe, MD, has no financial arrangement or affiliation with a corporate organization or a manufacturer of a product discussed in this program.

Michelle Graham, MD, has no financial arrangement or affiliation with a corporate organization or a manufacturer of a product discussed in this program.

Paul MacDonald, MD, has no financial arrangement or affiliation with a corporate organization or a manufacturer of a product discussed in this program.

Joel Parlow, MD, has no financial arrangement or affiliation with a corporate organization or a manufacturer of a product discussed in this program.

Daniel I. Sessler, MD, has no financial arrangement or affiliation with a corporate organization or a manufacturer of a product discussed in this program.

Sadeesh Srinathan, MD, has no financial arrangement or affiliation with a corporate organization or a manufacturer of a product discussed in this program.

Vikas Tandon, MD, has no financial arrangement or affiliation with a corporate organization or a manufacturer of a product discussed in this program.
disclamer

The opinions or views expressed on this publication are those of the authors and do not necessarily reflect the opinions and recommendations of the publisher or supporters. Articles may discuss pharmaceutical products and/or use of products that have not been approved by the US Food and Drug Administration or other regulatory authorities outside the United States. Dosages, indication, and methods of use for compounds that are referred to by the presenters/authors may reflect their clinical experience or may be derived from the professional literature or other sources. For approved product information, consult the manufacturer's prescribing information or the applicable regulatory authority.

Welcome to the Reducing Global Perioperative Risk Resource Center

Every year, more than 200 million adults across the globe undergo major non-cardiac surgery. Of these, more than 10 million will experience a major cardiac complication within the first 30 postoperative days. Major perioperative cardiac complications account for at least a third of perioperative deaths, and result in substantial morbidity, prolonged hospitalization, and increased costs.

faculty CO-CHAIRS

PJ Devereaux, MD, PhD, FRCPC
Director, Division of Cardiology
McMaster University Senior Scientist
and Scientific Leader of the
Anesthesiology, Perioperative
Medicine, and Surgical Research
Group
Population Health Research Institute
Hamilton, ON Canada
Michael McGillion, RN, PhD
Associate Professor and Assistant Dean,
Research
Scientist, Population Health Research
Institute
School of Nursing, Faculty of Health
Sciences
McMaster University
Hamilton, ON Canada

PJ Devereaux, MD, PhD, FRCPC

Director, Division of Cardiology McMaster University Senior Scientist and
Scientific Leader of the Anesthesiology, Perioperative Medicine, and Surgical
Research Group
Population Health Research Institute, Hamilton, ON Canada

Michael McGillion, RN, PhD

Associate Professor and Assistant Dean, Research
Scientist, Population Health Research Institute
School of Nursing, Faculty of Health Sciences
McMaster University, Hamilton, ON Canada

What’s new

GUIDELINES STUDY

The prognostic value of pre-operative and post-operative B-type natriuretic peptides in patients undergoing noncardiac surgery: B-type natriuretic peptide and N-terminal fragment of pro-B-type natriuretic peptide: a systematic review and individual patient data meta-analysis

Rodseth RN, Biccard BM, Le Manach Y, et al. J Am Coll Cardiol. 2014;63:170-180

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Study type

Study title
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Authors, et al. Journal Name. 2014;63:170-180 [2-line limit?]

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IDENTIFICATION STUDY

Rodseth RN, Biccard BM, Le Manach Y, et al. J Am Coll Cardiol. 2014;63:170-180

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GUIDELINES STUDY

Study title
Limited to two lines ?…

Authors, et al. Journal Name. 2014;63:170-180 [2-line limit?]

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MANAGEMENT STUDY [VIDEO ONLY]

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CCS Perioperative Guidelines

Educational Lecture Series—CCS Perioperative Guidelines

A panel of experts provide an overview of the Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients who undergo Non-Cardiac Surgery.

Now playing: Introduction, Methods, and Target Population

Lecture chapters

show list

Introduction, Methods, and Target Population

Michelle Graham, MD
Cardiac Risk Assessment: Clinical Risk Scores, Functional Capacity and Biomarkers

Sadeesh Srinathan, MD
Cardiac Risk Assessment: Cardiac Imaging and Stress Tests

Vikas Tandon, MD
Perioperative Cardiac Risk Modification

Joel Parlow, MD
Monitoring for Perioperative Cardiac Events

Emmanuelle Duceppe, MD
Management of Perioperative Complications

Paul MacDonald, MD
Preoperative Risk Assessment and Postoperative Monitoring Flow Diagram and Guidelines Summary

Daniel I. Sessler, MD

Practice Guidelines

Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery

Duceppe E, Parlow J, MacDonald P, et al

Can J Cardiol. 2016 Oct 4. pii: S0828-282X(16)30980-1. doi: 10.1016/j.cjca.2016.09.008

Important Supplementary Material

Key Findings RAM

A challenge to RAM is regional connectivity. Connectivity issues are predominant in remote and densely populated areas where cellular reception is subjected to available infrastructure.
Key to the optimal design of future RAM trials is the acquisition of big data through large-scale, prospective, observational studies and adequately powered RCT’s with selective deployment of RAM, incorporation of biomarkers and machine learning.

Key Highlights RAM

Current systems for postoperative monitoring in surgical populations on hospital wards and at home are inadequate, with infrequent vital signs monitoring contributing to thousands of cases of undetected or delayed detection of hemodynamic compromise.
Remote automated monitoring (RAM), a subcomponent of telemedicine, is improving with technological advances that enable data integration and synthesis, as well as directed frontline nurse response, especially in surgical wards and at home.
This article reviewed work to date on postoperative RAM on surgical wards and strategies to advance this field.

Welcome Message

Learn more about the Reducing Global Perioperative Risk Resource Center

SUGGESTED RESEARCH

Prognostic capabilities of coronary computed tomographic angiography before non-cardiac surgery: Prospective cohort study

Sheth T, Chan M, Butler C, et al. BMJ. 2015;350:h1907.

Interventions for preoperative smoking cessation

Thomsen T, Villebro N, Moller AM. Cochrane Database Syst Rev. 2014;3:CD002294.

Coronary-artery revascularization before elective major vascular surgery

McFalls EO, Ward HB, Moritz TE, et al. N Engl J Med. 2004;351:2795-2804.

Myocardial injury after noncardiac surgery: A large, international, prospective cohort study establishing diagnostic criteria, characteristics, predictors, and 30-day outcomes

Botto F, Alonso-Coello P, Chan MT, et al. Anesthesiology. 2014;120:564-78.

Statement of Peer Review

Disclaimer Statement

Disclosure of Funding

Faculty Disclosures

Guest Editors

Program Participants

Header

Reducing Global Perioperative Risk

Topics

Welcome to the Reducing Global Perioperative Risk Resource Center

faculty CO-CHAIRS

PJ Devereaux, MD, PhD, FRCPC

Michael McGillion, RN, PhD

What’s new

GUIDELINES STUDY

Study type

Study title
Limited to two lines ?…

IDENTIFICATION STUDY

GUIDELINES STUDY

Study title
Limited to two lines ?…

MANAGEMENT STUDY [VIDEO ONLY]

Topics

Educational Lecture Series—CCS Perioperative Guidelines

Lecture chapters

Practice Guidelines

Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery

Key Findings RAM

Key Highlights RAM

Welcome Message

SUGGESTED RESEARCH

CLINICIAN resources

FOR YOUR PATIENTS

Topics

Educational Lecture Series—CCS Perioperative Guidelines

Lecture chapters

Practice Guidelines

Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery

Key Findings RAM

Key Highlights RAM

Welcome Message

RELATED RESEARCH

SUGGESTED RESEARCH