Challenging Paradigms and Trusting Evidence: New Approaches to Perioperative Care.

the novel perspectives on the complexities of clinical perioperative care are impera-tive. This issue of Seminars in Cardiothoracic and Vascular Anesthesia (SCVA) emphasizes this ethos. Two original research studies evaluate methods to reduce the quantity of anesthetic and opioid medications needed for surgery, and a comprehensive two-part review evaluates the evidence for “ prehabilitation ” before cardiac surgery. This issue is rounded out by two systematic reviews on the use of TEE in liver transplantation, and two case reports describing the challenging management of intracardiac masses. This literature will guide readers towards a more patient-centered approach with less dependence on polypharmacy and, hopefully, optimize outcomes for cardiac surgery. This approach is all the more relevant as the population ages; surgical populations are aging faster than the general population and phrases like “ potentially inappropriate medications ” and “ deprescribing ” entered the perioperative lexicon. we the the are visible on the horizon and the of famed to The you know, the less you