循環器ジャーナル68巻3号

2020年07月発行

特集 不整脈治療の最新デバイステクノロジーとリードマネジメント Ⅲ．植込みデバイス手術の合併症

出血性合併症の予防

著者： 森本大成¹

所属機関： ¹大阪医科大学外科学講座胸部外科学教室

ページ範囲：P.484 - P.489

Point
・デバイス手術での出血性合併症の原因の多くは手術手技である．
・予防のためには適切な手術手技の習得が必要である．
・抗凝固療法を受けている患者のデバイス手術では，薬剤中止の利点・欠点を十分に考慮して決定する必要がある．

参考文献

1) 清水　宏：あたらしい皮膚科学　第3版，中山書店，2018

2) 森本大成：リード挿入・デバイス植込みの手技に伴う合併症．奥村謙（編）：心臓リズムマネージメントを究める，P360-364，メジカルビュー社，2009

3) Byrd CL:Management of implant complications. In:Ellenbogen KA, Kay GN, Wilkoff BL, ed:Clinical cardiac Pacing and Defibrillation. 2nd ed. W.B. Saunders, Philadelphia, pp.674-675, 2000

4) Zhen ZJ, Lai EC, Lee QH, et al:Conventional wound management versus a closed suction irrigation method for infected laparotomy wound--a comparative study. Int J Surg 9:378-381, 2011

5) 石川くみ子，大川真一郎，千田宏司，他：ペースメーカー・リード心筋穿通例についての臨床病学的検討．心臓ペーシング10:25, 1994

6) 渡辺　寛，池田晃治，井出博文，他：Screw-in心内膜導線により右室穿孔を合併し心タンポナーデを呈した3例．心臓ペーシング10:259, 1994

7) Healey JS, Eikelboom J, Douketis J, et al:Periprocedural bleeding and thromboembolic events with dabigatran compared with warfarin:results from the Randomized Evaluation of Long-Term Anticoagulation Therapy（RE-LY）randomized trial. Circulation 126:343-348, 2012

8) Sherwood MW, Douketis JD, Patel MR, et al:Outcomes of temporary interruption of rivaroxaban compared with warfarin in patients with nonvalvular atrial fibrillation:results from the rivaroxaban once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation（ROCKET AF）. Circulation 129:1850-1859, 2014

9) Garcia D, Alexander JH, Wallentin L, et al:Management and clinical outcomes in patients treated with apixaban vs warfarin undergoing procedures. Blood 124:3692-3698, 2014

10) Birnie DH, Healey JS, Wells GA, et al:BRUISE CONTROL Investigators:Pacemaker or defibrillator surgery without interruption of anticoagulation. N Engl J Med 368:2084-2093, 2013

11) Essebag V, Verma A, Healey JS, et al:BRUISE CONTROL Investigators:Clinically Significant Pocket Hematoma Increases Long-Term Risk of Device Infection:BRUISE CONTROL INFECTION Study. J Am Coll Cardiol 67:1300-1308, 2016

12) AlTurki A, Proietti R, Birnie DH, et al:Management of antithrombotic therapy during cardiac implantable device surgery. J Arrhythm, 32:163-169, 2016

13) Birnie DH, Healey JS, wells GA, et al:BRUISE CONTROL-2 Investigators:Continued vs. interrupted direct oral anticoagulants at the time of device surgery, in patients with moderate to hight risk of arterial thrombo-embolic events（BRUISE CONTROL-2）. Eur Heart J 39, 3973-3979, 2018

14) Bernard ML, Shotwell M, Nietert PJ, et al:Meta-Analysis of Bleeding Complications Associated With Cardiac Rhythm Device Implantation. Circ Arrhythm Electrophysiol 5:468-474, 2012

15) Tompkins C, Cheng A, Dalal D, et al:Dual Antiplatelet Therapy and Heparin “Bridging” Significantly Increase the Risk of Bleeding Complications After Pacemaker or Implantable Cardioverter-Defibrillator Device Implantation. J Am Coll Cardiol 55:2376-2382, 2010

16) Kristensen SD, Knuuti J, Saraste A, et al:Authors/Task Force Members:2014 ESC/ESA Guidelines on non-cardiac surgery:cardiovascular assessment and management:The Joint Task Force on non cardiac surgery:cardiovascular assessment and management of the European Society of Cardiology（ESC）and the European Society of Anaesthesiology（ESA）. Eur Heart J 35:2383-2431, 2014

17) 日本臨床検査医学会：診断群別臨床検査のガイドライン　医療の標準化に向けて．2003