The AHA Guidelines and Scientific Statements Handbook

Chapter 8 Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery

Fig. 8.2 Proposed approach to the management of patients with previous percutaneous coronary intervention (PCI) who require noncardiac
surgery, based on expert opinion.

Balloon

angioplasty

Bare-metal

stent

Drug-eluting

stent

14 to 29 days 30 to 365 days Greater than 365 days

Acute MI, high-risk ACS,

or high-risk cardiac

anatomy

Timing of Surgery

Bleeding risk of surgery Low Stent and continued dual antiplatelet therapy

Not low

MI indicates myocardial infarction and ACS, acute coronary syndrome

Fig. 8.3 Treatment for patients requiring percutaneous coronary intervention who need subsequent surgery. ACS indicates acute coronary
syndrome; COR, class of recommendation; LOE, level of evidence; and MI, myocardial infarction.