2025年SCAI/HRS 临床实践指南 通过导管治疗左心室尾闭塞
Andrew M Goldsweig1, Michael Glikson2, Jacqueline Joza3
1Department of Cardiovascular Medicine, Baystate Medical Center and Division of Cardiovascular Medicine, University of Massachusetts-Baystate, Springfield, Massachusetts.
概括
左心房尾阻塞 (LAAO) 装置有助于预防心房患者的中风. 这些指导方针为LAAO患者选择,成像和管理诸如周围设备泄漏等并发症提供了基于证据的建议.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 电力生理学 电力生理学
背景情况:
- 与没有抗凝药相比,左心房尾闭塞 (LAAO) 装置有效降低心房患者中风风险.
- 关于最佳的患者选择,成像,抗血栓治疗和周围设备泄漏 (PDL) 和设备相关血栓 (DRT) 的管理,实践中存在差异和不确定性.
研究的目的:
- 为临床医生,患者和利益相关者提供基于证据的LAAO管理指南.
- 解决护理方面的差异,并支持LAAO程序的决策.
主要方法:
- 一个多学科的指导方针小组由心血管血管血管图和干预协会和心律协会召开.
- 使用推评估,开发和评价 (GRADE) 方法制定了建议,通过系统审查和证据决策框架进行了评估.
主要成果:
- 制定了八项基于证据的建议,以解决LAAO护理的变化.
- 确定了两个关键的知识差距,突出了未来研究的领域.
结论:
- 关键建议侧重于患者选择,周围手术成像,抗血栓治疗和PDL和DRT的管理.
- 建议在LAAO和PDL后对单抗血小板治疗进行未来的研究.
相关概念视频
Cardiac Catheterization III: Left Heart Catheterization
592
Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
592
Cardiac Catheterization IV: Nursing Management
656
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
656
Aortic Regurgitation III: Medical Management
397
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
397
Mitral Stenosis III: Medical Management
247
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
247
Acute Coronary Syndrome IV: Interprofessional Care
220
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...
220
Acute Coronary Syndrome V: Nursing Management
271
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
271


