Approach to Noncardiac Surgery in Cardiac Patients: Feasibility of Simultaneous Cardiac and Noncardiac Surgery

The study aimed to investigate the feasibility of simultaneous cardiac and noncardiac surgery at a tertiary care high-volume center.The clinical records of all patients who underwent simultaneous cardiac and noncardiac surgery between July 2017 and July 2022 were reviewed.Preoperative, intraoperative, and postoperative clinical data were collected and analyzed.Patients were followed up to hospital discharge.Fourteen patients underwent simultaneous cardiac and noncardiac surgery.Patients were hemodynamically stable throughout the follow-up.Postoperative elective intermittent positive pressure ventilation (IPPV) duration was 4-8 hours (mean 5.4 ± 1.1 hours).The intensive care unit (ICU) stay varied between 3 and 22 (mean of 7.9 ± 6.4) days, and the total hospital stay varied from 8 to 30 (mean of 13.8 ± 6.8) days.None of the patients developed postoperative complications, namely bleeding needing re-exploration, pulmonary infection with hypoxemia, acute renal failure, or wound infection.There were no perioperative major adverse cardiac events such as myocardial infarction, heart failure, significant life-threatening arrhythmia, cardiac arrest, or acute ischemic stroke during the index hospital stay.There was no mortality in this cohort.Simultaneous cardiac and noncardiac surgery in patients who are suffering from heart disease is safe and feasible with a satisfactory postoperative outcome when stepwise stratification and evaluation during the preoperative period and efficient and expert management during the perioperative period have been executed.