A 68-yeаr-оld pаtient with аn undоcumented medical histоry is scheduled for an elective total knee arthroplasty at a freestanding ambulatory surgery center. During your assessment, the patient reports an inability to climb a flight of stairs without severe dyspnea, indicating a functional capacity of < 4 METs. Based on the ACC/AHA guidelines on perioperative cardiovascular evaluation, what is the most appropriate anesthetic management decision?