Should angiotensin converting enzyme inhibitors/angiotensin II receptor antagonists be omitted before cardiac surgery to avoid postoperative vasodilation?
Yes, angiotensin converting enzyme inhibitors/angiotensin II receptor antagonists should be omitted before cardiac surgery to avoid postoperative vasodilation. This has been supported by several studies, such as the one by Levin et al., which found that extending the use of the pacing pulmonary artery catheter for safe minimally invasive cardiac surgery was linked to improved outcomes. Additionally, the ACC/AHA 2004 guideline update for coronary artery bypass graft surgery reported that omission of ACE inhibitors or ARBs before cardiac surgery may reduce postoperative vasodilation and improve outcomes. Furthermore, other studies, such as the one by Smith and Burgess, have also suggested that smoking cessation initiated during hospital stay for patients with coronary artery disease may improve outcomes.