Geriatric patients are a significant proportion of the patients seen in the
perioperative setting. Oftentimes, these patients are presenting for non-cardiac surgery
after undergoing a cardiac procedure previously. Management of these patients starts
with understanding the pathophysiology, surgical intervention, and anesthetic
considerations. This management starts from risk assessment and perioperative
management. In this chapter, risk assessment stemming from a patient’s co-morbid
conditions is taken into account to form an overall risk profile. These conditions help
the anesthesiologist establish a framework to model an anesthetic plan. Notably, a prior
cardiac history, including a history of coronary artery disease (CAD), hypertension
(HTN), and a history of valve disease and possible repair, is prudent. Also discussed is
the need for appropriate intra-operative monitoring in specific situations as well as
anticoagulation guidelines in the pre and post-operative settings.
Keywords: Anticoagulation, Cardiac stents, Geriatric anesthesia, Preoperative cardiac testing, Intra-operative monitoring, Valve replacement, Post-operative considerations.
