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Cardiac Catheterization III: Left Heart Catheterization01:24

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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経口抗凝固薬の使用とLAAOS IIIにおける左心房閉塞

Stuart J Connolly1, Jeff S Healey1, Emilie P Belley-Cote1

  • 1Population Health Research Institute, Hamilton Health Sciences, McMaster University, Ontario, Canada (S.J.C., J.S.H., E.P.B.-C., K. Balasubramanian, K. Brady, P.J.D., M.S., C.R., S.Y., R.P.W.).

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まとめ

心臓外科手術を受ける心房細動患者では,左心房細動 (LAA) 閉塞が脳卒中リスクを効果的に軽減します. この効果は,患者が口服抗凝固剤 (OAC) を使用しているかどうかにかかわらず一貫しています.

キーワード:
抗凝固剤心房付属体心房細動ストローク

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科学分野:

  • 心臓病科
  • 血管 外科
  • トロンボシス 研究

背景:

  • 心臓外科手術中の心房細動患者の脳卒中リスクを減らすことが証明されています.
  • 経口抗凝固剤 (OAC) の使用の変動は,LAA閉塞の有効性に影響を与える可能性があります.

研究 の 目的:

  • OAC 療法による脳卒中リスク減少に対する LAA 閉塞の影響を調べる.
  • LAA閉塞の利点はOAC使用とは無関係であるかどうかを判断する.

主な方法:

  • LAAOS III試験のデータを活用し,フォローアップ訪問でOACの使用情報を収集しました.
  • 脳卒中のリスクを分析するために,時間依存の共変数で調整された比例リスクモデルを使用した.
  • ランダム化後の複数の時点での脳卒中リスクの評価

主要な成果:

  • LAA閉塞は,様々なOAC使用グループで一貫した脳卒中リスク低下を示した (HRは0. 63から0. 76).
  • OACの使用を時間依存の共変数として用いた分析は,OACの状態に関係なく,LAA閉塞の同様の脳卒中減少を示した.

結論:

  • OACの併用療法に関係なく,LAA閉塞による血栓塞栓リスク減少の利点は一貫しています.
  • LAA閉塞は,OACの使用にかかわらず,心房細動患者のための貴重な脳卒中予防戦略を提供します.