[Minimizing perioperative risk - an interdisciplinary effort].

Physicians involved in perioperative care have to face new challenges because of the continuing aging of the population and medical progress, which facilitates even more invasive surgery. The risk of surgical procedures is elevated in patients with cardiac co-morbidity necessitating an optimization of both clinical condition and preoperative therapy of these patients. Innovative therapeutic concepts like fast-track surgery, new approaches in coronary revascularisation, and new strategies of anticoagulation require an interdisciplinary treatment of these patients and a strict collaboration of surgeons and anaesthesiologists with the colleagues from other nonsurgical disciplines like internal medicine and cardiology. Physicians should start beforehand the interdisciplinary preparation of surgical patients as out-patients and should continue this approach during the stay in hospital. In this review, we describe the major perioperative cardiac, pulmonary and vascular risks for physicians involved in the treatment of surgical patients.