The PeriOP-CARE HF trial will evaluate whether combining systematic preoperative screening using an NT-proBNP-triggered standardised preoperative evaluation with interdisciplinary, multimodal and individually optimised treatment throughout the entire perioperative period will reduce postoperative morbidity in patients aged > 65 years undergoing major surgery with intermediate to high surgical risk according to the current ESC guidelines [3]. Here, NPPB is linked to hydrops fetalis.