Tom 13, Nr 6 (2018)
CHOROBY STRUKTURALNE SERCA
Opublikowany online: 2019-02-04
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Leczenie przeciwkrzepliwe po przezskórnym zamknięciu uszka lewego przedsionka
Kardiol Inwazyjna 2018;13(6):18-22.
Streszczenie
Przezskórne zamknięcie uszka lewego przedsionka (LAAO, left
atrial appendage occlusion) zmniejsza ryzyko udaru mózgu
w grupie chorych z migotaniem przedsionków o etiologii niezastawkowej
i wyraźnie ogranicza liczbę powikłań krwotocznych
poprzez eliminację konieczności długotrwałego leczenia
przeciwzakrzepowego u większości chorych. Jednak w okresie
bezpośrednio po zabiegu LAAO konieczne jest przejściowe, ograniczone
czasowo, stosowanie terapii przeciwkrzepliwej. Jakość
i długość optymalnej terapii po LAAO pozostają przedmiotem
badań. Obecnie schemat podwójnej terapii przeciwpłytkowej
w okresie pierwszych trzech miesięcy i następnie kwasem
acetylosalicylowym przynajmniej przez rok jest rutynowo
stosowany u wszystkich pacjentów po LAAO, zapewniając
skuteczną ochronę przed udarem przy ograniczonej liczbie
powikłań krwotocznych.
Słowa kluczowe: zamknięcie uszka lewego przedsionkaleczenie przeciwzakrzepowe
Referencje
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