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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Venous Thrombosis III: Interprofessional Care01:29

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Acute Coronary Syndrome IV: Interprofessional Care01:28

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IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
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Peripheral Artery Disease III: Interprofessional Care01:27

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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Pericarditis III: Medical Management01:17

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The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
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Heart Failure VI: Adjunct Therapies01:22

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Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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Related Experiment Video

Updated: Mar 29, 2026

Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter
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Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter

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Antithrombotic Therapy in Percutaneous Atrial Structural Interventions.

Konstantinos Pitsikakis1, Ioannis Skalidis2, Emmanuel Skalidis1

  • 1Department of Cardiology, University Hospital of Heraklion, Voutes, Leof Panepistimiou, 71500 Iraklio, Greece.

Journal of Cardiovascular Development and Disease
|March 27, 2026
PubMed
Summary

Optimal antithrombotic strategies after left atrial appendage occlusion (LAAO), patent foramen ovale (PFO), and atrial septal defect (ASD) closure are uncertain. Evidence synthesis highlights inconsistent practices and the need for standardized, individualized approaches to prevent device-related thrombus.

Keywords:
anticoagulant therapyantiplatelet therapyatrial septal defect closureleft atrial appendage occlusionpatent foramen ovale closurepostprocedural antithrombotic strategies

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Device Thrombosis

Background:

  • Percutaneous closure of left atrial appendage (LAAO), patent foramen ovale (PFO), and atrial septal defect (ASD) require antithrombotic therapy to prevent device-related thrombus during healing.
  • Current antithrombotic regimens are inconsistent across clinical practices, lacking standardized protocols.

Purpose of the Study:

  • To review and synthesize current evidence on postprocedural antithrombotic strategies for LAAO, PFO, and ASD closure.
  • To compare the efficacy and safety of different antithrombotic regimens.
  • To identify knowledge gaps and areas for future research.

Main Methods:

  • Systematic review of contemporary evidence on antithrombotic therapies post-LAAO, PFO closure, and ASD closure.
  • Comparison of efficacy and safety data from observational studies and limited clinical trials.
  • Analysis of current clinical practice variations and surveillance protocols.

Main Results:

  • For LAAO, direct oral anticoagulants (DOACs) show promise, but device-related thrombus remains a concern, and imaging protocols vary.
  • For PFO and ASD closure, antiplatelet-only strategies (dual then single) are common, with potential for simplified or abbreviated regimens.
  • High-quality comparative trials are scarce, leading to ongoing debate on optimal therapy, duration, and surveillance.

Conclusions:

  • Optimal antithrombotic therapy, duration, and surveillance post-atrial structural interventions remain debated.
  • Standardized imaging definitions, robust randomized trials, and individualized risk-based frameworks are crucial for optimizing patient care.
  • Further research is needed to establish evidence-based, personalized antithrombotic strategies.