When Is It Safe to Operate Following Myocardial Infarction?

Trio Best PracticeTRIO Best Practice articles are brief, structured reviews designed to provide the busy clinician with a handy outline and reference for day-to-day clinical decision making. The ENTtoday summaries below include the Background and Best Practice sections of the original article. To view the complete Laryngoscope articles free of charge, visit Laryngoscope.com.


History of recent myocardial infarction (MI) is known to be a significant risk factor for postoperative complications following elective, noncardiac surgery (NCS). Recommendation regarding the optimal time for elective surgery following MI has changed over time as additional data have become available. Herein, we examine the current evidence and recommendation regarding the most appropriate time interval for elective NCS following MI to minimize morbidity and mortality.

Best Practice

Elective noncardiac surgery should be delayed by at least 60 days following MI, with complication risks further decreasing over time but persisting above baseline. Prior to such operations, the use of an approved cardiac risk calculator and functional status index should guide further management. Optimal preoperative evaluation requires the involvement of and communication between the entire patient care team, including the patient, surgeon, anesthesiologist, primary care physician, and any necessary consultants (Laryngoscope. 2016;126:299-301).