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Kawasaki Disease and General Anesthesia for Dental Treatment: A Case Report
Sarah LeeDDS,
David B. GuthrieDMD, and
Ralph H. EpsteinDDS
Article Category: Case Report
Volume/Issue: Volume 68: Issue 3
Online Publication Date: Oct 04, 2021
DOI: 10.2344/anpr-68-01-06
Page Range: 146 – 153

uncertainty of dental treatment needs, the hematologist stopped both aspirin and warfarin and prescribed subcutaneous injections of enoxaparin for bridging anticoagulation. The patient received his final dose of enoxaparin the night before the procedure as planned. On the day of surgery, the patient arrived at the preoperative holding area accompanied by his parents and 2 older siblings. His physical examination was normal. His baseline vitals by fingertip pulse oximetry included a heart rate of 85 beats per minute (bpm) and oxygen saturation of 99% on room air. All

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Figure 1.; Transthoracic echocardiogram image demonstrating patient's giant tubular aneurysm of the right coronary artery (RCA) measuring 10.04 mm maximal diameter; Z score 18.7 (red arrow).
Sarah Lee,
David B. Guthrie, and
Ralph H. Epstein
Figure 1.
Figure 1.

Transthoracic echocardiogram image demonstrating patient's giant tubular aneurysm of the right coronary artery (RCA) measuring 10.04 mm maximal diameter; Z score 18.7 (red arrow).

Figure 2.; Transthoracic echocardiogram image demonstrating patient's aneurysm of the left anterior descending artery (LAD) measuring 4.29 mm maximal diameter; Z score 4.3 (red arrow).
Sarah Lee,
David B. Guthrie, and
Ralph H. Epstein
Figure 2.
Figure 2.

Transthoracic echocardiogram image demonstrating patient's aneurysm of the left anterior descending artery (LAD) measuring 4.29 mm maximal diameter; Z score 4.3 (red arrow).

Figure 3.; Patient's vitals recorded throughout the procedure in 3-minute increments. See legend on top right corner.
Sarah Lee,
David B. Guthrie, and
Ralph H. Epstein
Figure 3.
Figure 3.

Patient's vitals recorded throughout the procedure in 3-minute increments. See legend on top right corner.

Figure 4.; §“High-risk” coronary artery aneurysms (CAAs): Other experts may consider additional high-risk features, such as long length and distal location of aneurysms, large total number of CAAs, multiple branches affected, luminal irregularities, vessel wall abnormalities (calcification, luminal thrombosis, previous myocardial infarction, and ventricular dysfunction).10 £Low-dose aspirin: 3–5 mg/kg once daily).
Sarah Lee,
David B. Guthrie, and
Ralph H. Epstein
Figure 4.
Figure 4.

§“High-risk” coronary artery aneurysms (CAAs): Other experts may consider additional high-risk features, such as long length and distal location of aneurysms, large total number of CAAs, multiple branches affected, luminal irregularities, vessel wall abnormalities (calcification, luminal thrombosis, previous myocardial infarction, and ventricular dysfunction).10 £Low-dose aspirin: 3–5 mg/kg once daily).

Perioperative Management of Oral Antithrombotics in Dentistry and Oral Surgery: Part 1
Benjamin J. StatmanDDS
Article Category: Other
Volume/Issue: Volume 69: Issue 3
Online Publication Date: Oct 06, 2022
DOI: 10.2344/anpr-69-03-05
Page Range: 40 – 47

ANTICOAGULATION Anticoagulation with oral agents is an essential component when treating patients with active thromboses or to prevent thromboembolic complications in patients with atrial fibrillation, mechanical heart valves, venous thromboembolism (VTE), pulmonary embolism, or elevated VTE risk. About 6 million patients are on long-term anticoagulation in the United States. 14 This number is rising due to an aging population, higher age-adjusted incidence of chronic illness, and advances in early detection of elevated thromboembolic risk. Since the 1950s, vitamin K

Perioperative Management of Oral Antithrombotics in Dentistry and Oral Surgery: Part 2
Benjamin J. StatmanDDS
Article Category: Research Article
Volume/Issue: Volume 70: Issue 1
Online Publication Date: Mar 28, 2023
DOI: 10.2344/anpr-70-01-06
Page Range: 37 – 48

Table 1. Periprocedural Thrombotic Risk Stratification 1 Thromboembolic Risk The American College of Chest Physicians (ACCP) and the International Society on Thrombosis and Haemostasis (ISTH) have both established a 3-tiered system stratifying patients into high, moderate, or low risk for perioperative thromboembolism ( Table 2 ). 4 – 6 For patients on anticoagulation for atrial fibrillation, risk is based on their CHA 2 DS 2 VASc score

Cardiovascular Considerations in Anesthetic Management for a Patient With Antiphospholipid Syndrome and Decreased Cardiac Function: A Case Study
Makiko ShibuyaDDS, PhD,
Yukifumi KimuraDDS, PhD,
Shigeru TakumaDDS, PhD,
Nobuhito KamekuraDDS, PhD, and
Toshiaki FujisawaDDS, PhD
Article Category: Case Report
Volume/Issue: Volume 68: Issue 1
Online Publication Date: Apr 07, 2021
DOI: 10.2344/anpr-67-03-07
Page Range: 33 – 37

and cerebral infarction comprises more than 90% of cases of arterial thrombus. 2 Myocardial infarction in the absence of coronary stenosis has also been reported in patients with APS, due to either coronary or microvascular thrombus formation. 3 – 6 Anticoagulation therapy with warfarin is considered the most effective treatment, and concomitant antiplatelet therapy (eg, aspirin, ticlopidine) is also used. 7 Furthermore, infection, invasive surgical procedures, and general anesthesia are known potential causes for catastrophic APS in which a patient presents with

Cardiovascular Drugs: Implications for Dental Practice Part 2—Antihyperlipidemics and Antithrombotics
Daniel E. BeckerDDS
Article Category: Research Article
Volume/Issue: Volume 55: Issue 2
Online Publication Date: Jan 01, 2008
DOI: 10.2344/0003-3006(2008)55[49:CDIFDP]2.0.CO;2
Page Range: 49 – 56

universal standard thromboplastin been used for the test. Actual intensity of anticoagulation varies according to risk for thromboembolic events. For example, INR values as low as 1.3–2.0 are effective prophylaxis for deep vein thrombosis, but 2.0–3.0 is required for atrial fibrillation and 3.5–4.5 may be required for patients with prosthetic heart valves. 13 There are no formal guidelines for managing anticoagulated patients during dental treatment. Decisions are empiric and, if in doubt, should be made in consultation with the patient's physician. However

JDSA Journal Abstracts
Article Category: Research Article
Volume/Issue: Volume 56: Issue 2
Online Publication Date: Jan 01, 2009
DOI: 10.2344/0003-3006-56.2.63
Page Range: 63 – 66

advice of the attending pediatric physician. We were careful to maintain normotension and normocapnia, and to avoid preoperative dehydration. A prophylactic administration of antibiotics for endocarditis and maintenance of anticoagulation therapy were necessary. The induction and maintenance of anesthesia were performed with nitrous oxide, oxygen and sevoflurane. His blood pressure was transiently reduced to 64/48 mmHg after the tracheal intubation. Then etilephrine (4 mg) was used, and the blood pressure was recovered to a normal range within 5 minutes after the