Ugeskrift for laeger
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Ugeskrift for laeger · Apr 2009
[Minor dentoalveolar surgery in patients ungergoing antithrombotic therapy].
Minor oral dentoalveolar surgery can be performed safely without interrupting treatment with vitamin K antagonists provided the INR is within therapeutic range. Platelet inhibitors such as aspirin and clopidogrel may increase the risk of bleeding, but the risk of disabling or fatal sequelae is generally higher if the treatment is stopped. Application of local haemostatic agents and postoperative mouthwashes with tranexamic acid are recommended. Any changes in antithrombotic therapy must be undertaken in collaboration with the patient's prescribing physician.
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Ugeskrift for laeger · Apr 2009
[Endoscopy in patients receiving anticoagulation or antiplatelet therapy].
Drugs that interfere with haemostasis are widely used for thromboembolic diseases and cardiovascular protection. Gastrointestinal bleeding is a well-known complication, and endoscopists are often faced with decisions concerning the safety of endoscopic procedures in these patients. Based on expert opinion and on data from observational studies, we suggest algorithms for the approach to acute and elective procedures based on procedural risk and on risks for thromboembolic episodes.
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Ugeskrift for laeger · Apr 2009
Review[Inherited cardiac diseases caused by Nav1.5 sodium channel mutations].
Contraction of the heart is achieved through a delicately regulated conduction of electrical impulses. A pivotal element in the impulse propagation is the depolarising sodium current responsible for the initial depolarisation of the cardiomyocytes. Recent research has shown that mutations in the gene encoding the cardiac sodium channel (SCN5A) is associated with both rare forms of ventricular arrhythmia, and with the most frequent form of arrhythmia, atrial fibrillation.
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Ugeskrift for laeger · Apr 2009
Review[Transcatheter replacement of the aortic valve--a novel treatment modality for high-risk patients].
Aortic stenosis is the most common valve disease and in line with the rising life expectancy, the population of patients with this disease is expected to rise in years to come. About one third of the patients evaluated for conventional surgical replacement of the aortic valve are dismissed due to high risk of complication as a result of age and occurrence of comorbidity. For this group of inoperable patients, a new treatment can be offered in the form of transcatheter replacement of the aortic valve. This article describes the method and the current experiences.
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We have experienced a growing demand from patients for minimally invasive cardiac surgery. ⋯ Endoscopic mitral valve surgery is an attractive alternative to conventional sternotomy with an attractive cosmetic result. This can be obtained without compromising quality or safety. This paper confirms that endoscopic mitral valve surgery is feasible and it provides the least invasive operative approach. The technique is currently our primary surgical approach for mitral valve disease.