在隔离的冠状动脉旁路移植中进行全面的深静脉血栓形成预防方案
John Eisenga1,2,3, Jennie Hocking1,4, Austin Kluis2
1Department of Cardiovascular Research, Baylor Scott and White, The Heart Hospital, Plano, Tex.
JTCVS open
|February 29, 2024
概括
深静脉血栓 (DVT) 在冠状动脉旁路移植后的低至中度风险患者中没有发生. 这项研究发现,在这组患者中,DVT的发病率为0%.
科学领域:
- 心血管外科心血管外科
- 血管医学 血管医学
- 血栓形成研究研究
背景情况:
- 深静脉血栓症 (DVT) 是一种严重的手术并发症,可能导致致命的肺栓塞.
- 冠状动脉旁路移植 (CABG) 后DVT的发生率尚不清楚.
- 目前的预防指南各不相同,有些人不建议对低至中度风险患者进行常规化疗预防.
研究的目的:
- 在接受CABG的中低风险患者中确定DVT的发病率.
- 在这个人群中评估激进的术后DVT预防的有效性.
- 评估二次结果,包括死亡率和血栓塞栓事件.
主要方法:
- 一个单中心的回顾性研究包括了在2022年4月至2023年1月期间接受隔离CABG的患者.
- 静脉血栓栓塞的低至中等风险患者接受了积极的DVT预防,接受了手术后的下肢静脉超声波.
- 排除标准包括并发门/大动脉手术,高VTE风险或非VTE抗凝药.
主要成果:
- 在包括的211名患者中没有检测到任何DVT病例.
- 在住院期间,发生了3次显著出血事件和1次中风.
- 出院后,记录了3次出血事件,1次死亡,1次过渡性缺血性发作,1次肺栓塞.
结论:
- 在低至中等风险的患者中观察到DVT的0%发病率,这些患者接受了与综合DVT预防的单独CABG.
- 住院出血和其他血栓栓塞事件的发生率分别为2.84%和0.47%.
- 在这个特定的患者队列中,积极的DVT预防似乎有效预防DVT.
相关概念视频
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.2K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.2K
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
696
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
696
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
181
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
181
01:11Overview of Systemic Veins
465
Systemic veins are crucial blood vessels that return deoxygenated blood from various body tissues back to the heart. There are three systemic veins that return deoxygenated blood to the heart, they are as follows.
The coronary sinus, the heart's principal vein, resides in the coronary sulcus on the heart's posterior aspect. This broad venous channel receives nearly all venous blood from the myocardium, the heart muscle. It is fed by three primary veins: the great cardiac vein, the...
The coronary sinus, the heart's principal vein, resides in the coronary sulcus on the heart's posterior aspect. This broad venous channel receives nearly all venous blood from the myocardium, the heart muscle. It is fed by three primary veins: the great cardiac vein, the...
465