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JCM
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Preoperative Optimization in Cardiac Surgery
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Preoperative Optimization in Cardiac Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 923

Special Issue Editor

Dr. Jason M. Ali

E-Mail Website
Guest Editor
Department of Cardiothoracic Surgery, Royal Papworth Hospital NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge CB2 0AY, UK
Interests: minimal-access cardiac surgery; risk scoring; EuroSCORE; postoperative outcomes; heart and lung transplantation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Preoperative optimization in cardiac surgery plays a crucial role in enhancing patient outcomes and reducing postoperative complications. This comprehensive approach involves the systematic evaluation and management of patients before undergoing cardiac surgical procedures. Key components of preoperative optimization include risk assessment, cardiovascular evaluation, optimization of comorbid conditions, and patient education. By addressing modifiable risk factors such as hypertension, diabetes, and smoking, preoperative optimization aims to improve overall cardiovascular health and reduce perioperative risks. Strategies may include medication adjustments, lifestyle modifications, and targeted interventions to optimize cardiac function and minimize surgical complications. Multidisciplinary collaboration among cardiologists, cardiac surgeons, anesthesiologists, and other healthcare professionals is essential in developing individualized preoperative plans tailored to each patient's specific needs. Through effective preoperative optimization, the goal is to enhance surgical outcomes, shorten hospital stays, and promote long-term cardiovascular health.

Dr. Jason M. Ali
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • preoperative optimization
  • cardiac surgery
  • risk assessment
  • comorbid conditions
  • multidisciplinary collaboration
  • perioperative risks
  • cardiovascular evaluation

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Published Papers (1 paper)

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Review

19 pages, 738 KB  
Review
The Use of Advanced Glycation End-Product Measurements to Predict Post-Operative Complications After Cardiac Surgery
by Divya S. Agrawal, Jose C. Motta and Jason M. Ali
J. Clin. Med. 2025, 14(17), 6176; https://doi.org/10.3390/jcm14176176 - 1 Sep 2025
Viewed by 608
Abstract
Background/Objectives: Frailty is increasingly recognised as an important contributor to outcomes following cardiac surgery. There are various measures of frailty described, but many include subjective assessments impacting reliability and reproducibility of measurement. A potential biomarker: advanced glycation end products (AGEs) have been [...] Read more.
Background/Objectives: Frailty is increasingly recognised as an important contributor to outcomes following cardiac surgery. There are various measures of frailty described, but many include subjective assessments impacting reliability and reproducibility of measurement. A potential biomarker: advanced glycation end products (AGEs) have been suggested to closely correlate with frailty. This may offer the opportunity to objectively measure frailty and have potential use in preoperative risk assessment. The objective and aim of this narrative review is to assess the association between AGEs and outcomes following surgery, in order to evaluate the use of AGEs for preoperative risk assessment. Methods: This review involved searching five databases including the following: MEDLINE (through Ovid), Embase, Cochrane, ClinicalTrials.gov, and a specified Google Scholar search for studies published between database inception and 20 February 2025. The 1142 identified articles were then subjected to various inclusion and exclusion criteria. This exclusion criteria included all articles that were not in the English language, studies involving patients under 18 years of age, and studies that were incomplete or for whom the data was not yet available. This left 11 articles for which a ‘related articles’ search was performed on Google Scholar on 6 March 2025, as per the PRISMA-S extension guidelines, to obtain all relevant articles available. In the end, data analysis was conducted on 13 articles with a total of 2402 participants. These were categorised by type of surgery before analysis was performed for each surgical category. The quality of evidence was assessed using ROBINS-I tool and a risk of bias table has been provided. This study was provided no external sources of funding. Results: Four out of the five studies in cardiac surgery showed a statistically significant association between AGE levels and post-operative complications and outcomes. This association was also seen across thoracic and general surgery. Association was demonstrated with various post-operative complications as well as mortality. These relationships are supported by various pathophysiological mechanisms, including the ability of AGEs to induce oxidative stress, activate inflammatory mediators, and cause endothelial dysfunction. Conclusions: There is a body of evidence supporting the association between AGEs level and cardiac surgical outcomes. This objective measure of frailty could have significant utility in preoperative risk assessment and offer the opportunity to identify patients who will benefit from undergoing prehabilitation. Full article
(This article belongs to the Special Issue Preoperative Optimization in Cardiac Surgery)
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