3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology

Abstract

The main aim of the guidelines is to update the concepts promulgated by its two predecessors, namely, the I and II Guidelines for Perioperative Evaluation of the Brazilian Society of Cardiology published in 2007 and 2011, respectively.1 When the systematic review of the collected evidence was conducted after five years since the last publication, we noticed a remarkable evolution of the knowledge on the subject, particularly in cardiology. In the perioperative environment, the physician needs to simultaneously gather concepts from different specialties to understand different aspects of the same problem and to optimize the language among clinicians, surgeons, anesthesiologists, and intensivists. Although problems related to other disciplines are addressed in this III Guidelines, we decided that the text should adopt the point of view of a cardiologist. In line with this decision, the III Guidelines incorporated the term cardiovascular and was thus termed Guidelines for Perioperative Cardiovascular Evaluation. Based on new findings, some novelties were included, such as new oral anticoagulants and surgical interventions in patients with dual antiplatelet therapy (DAPT), in patients with last generation stents. Anticoagulants and antiplatelet agents were discussed in more detail for specific surgical procedures, such as dental, dermatological, endoscopic, and ophthalmologic.