[The surgical risk in patients with cardiac diseases].

The increase in the number of patients with heart and circulatory diseases during selective surgical operations in the past decades is due to both the epidemiologic situation and the increase in the number of old and very old people. To ensure optimum perioperative care of these patients, the anaesthetist must know the degree of illness of each individual and the functioning state of the haemodynamic system. In this paper we show factors which increase the perioperative risk of cardiac complications.

[Modified bedside diagnosis in patients at risk for aortocoronary venous bypass surgery].

Early detection of perioperative complications during cardiosurgical operations is of differential diagnostic and differential therapeutic importance. Various risk groups of aortocoronary venous bypass operations have been analysed under different aspects: age, (not significant), implemented bypass rate (aneurysm resection 1.75/p less than 0.

[Perioperative complications in at-risk patients undergoing heart valve surgery].

The success of operations of the replacement of heart valves is disturbed by perioperative complications and early lethality. A valuation of the perioperative risk individually of patients with operations of the replacement of heart valves according to defined subgroups is controlled by the perioperative course. In order to achieve the registration of patients with perioperative lesion of the myocardium and/or low output syndrome, the bedside performance of a marker protein monitoring consisting of enzymes/isoenzymes (CK, CK-MB, ALAT) and the muscle protein myoglobin, respectively, is necessary.

[Therapy of perioperative myocardial damage in aortocoronary venous bypass surgery].

The perioperative lesion of the myocardium in heart-lung machine operation can on principle not be prevented despite complex measures of the protection of the myocardium and the individual monitoring of the patients, this particularly by including patients with high risk of ischaemia of the myocardium (instable angina pectoris, stenosis of the trunc and greatly restricted left-ventricular function, respectively) in former years. In a proved perioperative lesion of the myocardium the limitation of the myocardial lesion stands in the centre of intensive-medical measures with vasodilators and positive inotropic substances.

[Aortocoronary venous bypass operation in the elderly].

On the extended diagnosis for an aorto-coronary venous bypass operation, with a greater involvement of patients with instable angina pectoris symptomatik (inApS), left main artery disease (LAD), aneurysmal resection, and "bad" ventricle (ejection fraction global less than or equal to 30%), the preoperative risk was evaluated in n = 600 patients. In a total of n = 150 patients with preoperative high-risk constellation perioperative parameters were monitored to find complications (perioperative myocardial damage [PMD], cardiac low output syndrome [LOS]). Among them were n = 40 patients aged greater than 60 years (60-72), their average age being 62.