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Clin Cardiol J Volume 1 | Issue 1
December 04-05, 2017 Dallas, USA
International Conference on
Heart Congress, Vascular Biology and Surgeon’s Meeting
Operations in the internal carotid artery in patients with atrial fibrillation with using
dabigatran etexilate
Alexandr Korotkikh
Regional clinical hospital & Far Eastern State Medical University Russian Federation
Objective:
To evaluate the effectiveness of dabigatran etexilate in patients with atrial fibrillation who underwent
operative treatment at the ICA.
Materials and Methods:
From Sept 1, 2015 to Dec 27, 2016, in the Department of Vascular Surgery and
Cardiology was performed 694 operations on the ICA. Of these 94 (13,5%), surgery patients with atrial
fibrillation. The average age of patients in the main group 68,5 ± 8,5 years, the control group - 65,0 ± 10,2 years.
The comparison groups significantly differed in the following characteristics: postinfarction cardiosclerosis in
the anamnesis of the main group 25,5%, control – 15,0% (P-value – 0,015); NYHA functional class I, main group
16,0%, control – 31,0 % (P-value 0,002); NYHA functional class III, 18.1%, control 4.8% (P-value 0.00028);
diabetes mellitus main group 28.7%, controls 18,2% (P-value 0,024). All patients with atrial fibrillation for 5-7
days before surgery, warfarin was canceled and dabigatran etexilate was administered at a dose of 150 mg 2 times
a day. When optimal numbers of INRs were reached, surgery was performed. Operational criteria and the results
were evaluated in the endpoint - “stroke + lethality.”
Results and Discussion:
Total completed 84 CEA and CAS 10. The average time of operations of the main
group 44,5 ± 17,1 min, control group - 40,7 ± 9,5 min, P-value <0,05. The average time of occlusion of ICA at
CEA in the main group was 13,7 ± 6,1 min, in the control group 13,1 ± 1,8 min, P-value> 0,05. In patients with
atrial fibrillation surgery performed significantly longer, but the time of the main stage - clamping ICA, were not
significantly different. Consequently, an increase in the time of surgery is associated with a longer hemostasis at
the stage of allotment of the ICA and/or after removal of the clamps off the arteries. In the early postoperative
period, extensive hematomas in the postoperative areas and sites of arterial puncture were not noted. Indicator
“stroke + lethality” inobservation group was 0%.
Conclusions:
CEA and CAS in patients with atrial fibrillation receiving dabigatran etexilate are effective and
safe. When performing CEA, additional time is required for more thorough hemostasis.
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