[1]赵志宏,王赛华,罗 俊,等.左心耳封堵联合二尖瓣球囊扩张治疗非风湿性二尖瓣狭窄伴心房颤动[J].介入放射学杂志,2022,31(03):285-289.
 ZHAO Zhihong,WANG Saihua,LUO Jun,et al.Left atrial appendage occlusion combined with percutaneous balloon mitral valvuloplasty for non-rheumatic mitral stenosis with atrial fibrillation[J].journal interventional radiology,2022,31(03):285-289.
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左心耳封堵联合二尖瓣球囊扩张治疗非风湿性二尖瓣狭窄伴心房颤动()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
31
期数:
2022年03
页码:
285-289
栏目:
临床研究
出版日期:
2022-03-25

文章信息/Info

Title:
Left atrial appendage occlusion combined with percutaneous balloon mitral valvuloplasty for non-rheumatic mitral stenosis with atrial fibrillation
作者:
赵志宏 王赛华 罗 俊 武英彪 王 菲 朱 茜 方 明 张小刚 郇 强 田 蓓 顾 薇 朱珞宁 宁忠平
Author(s):
ZHAO Zhihong WANG Saihua LUO Jun WU Yingbiao WANG Fei ZHU Qian FANG Ming ZHANG Xiaogang HUAN Qiang TIAN Bei GU Wei ZHU Luoning NING Zhongping.
Department of Cardiology, Affiliated Zhoupu Hospital, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China
关键词:
【关键词】 非风湿性二尖瓣狭窄 心房颤动 左心耳封堵 二尖瓣球囊扩张术
文献标志码:
A
摘要:
【摘要】 目的 分析非风湿性二尖瓣狭窄伴心房颤动患者经皮左心耳封堵术和二尖瓣球囊扩张术(PBMV)临床特点。方法 入选2018 年1 月至2020 年10 月上海健康医学院附属周浦医院确诊的4例非风湿性二尖瓣狭窄伴心房颤动患者,给予左心耳封堵术及左心耳封堵联合PBMV术治疗,对患者临床表现、影像学特征及治疗预后进行分析。结果 4 例患者年龄57~70岁,超声心动图诊断为非风湿性中重度二尖瓣狭窄。左心房CTA及经食管超声心动图(TEE)评估左心房后,1例中度二尖瓣狭窄患者仅行左心耳封堵,3例在左心耳封堵同时行PBMV,其中1例左心耳远端血栓形成,术中应用脑保护装置。左心耳封堵影像学结果显示4例患者左心耳封堵均获成功,围手术期均未发生心脏压塞、恶性心律失常、急性心肌衰竭、严重二尖瓣反流等并发症。术后3个月复查TEE,无封堵器相关左心房血栓形成,随访6~12个月均无心脑血管事件发生,患者生活质量显著改善。结论 左心耳封堵联合PBMV治疗非风湿性二尖瓣中重度狭窄伴心房颤动患者安全可行,但需严格把握适应证。

参考文献/References:

[1] Wang Z, Chen Z, Wang X,et al. The disease burden of atrial fibrillation in China from a National Cross- sectional Survey[J]. Am J Cardiol, 2018, 122:793-798.
[2] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会. 中国左心耳封堵预防心房颤动卒中专家共识(2019)[J]. 中华心血管病杂志, 2019, 47:937-955.
[3] Murdoch D,McAulay L,Walters DL. Combined percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation for rheumatic mitral stenosis and atrial fibrillation. Cardiovascular revascularization medicine: including molecular interventions[J]. Cardiovasc Revasc Med, 2014, 15:428- 431.
[4 ] Mangieri A,Montorfano M,Stella S,et al. Severe mitral stenosis and persistent left appendage thrombosis: when an old percutaneous solution meets new percutaneous strategies[J]. JACC Cardiovasc Interv, 2018,11:e11- e13.
[5] 中华医学会心电生理和起搏分会, 中国医师协会心律学专业委员会, 心房颤动防治专家工作委员会. 左心耳干预预防心房颤动患者血栓栓塞事件:目前的认识和建议(2019)[J]. 中华心律失常学杂志, 2019, 23:372-392.
[6] 中国医师协会心血管内科医师分会结构性心脏病专业委员会. 中国经导管左心耳封堵术临床路径专家共识[J]. 中国介入心脏病学杂志, 2019, 27:661- 672.
[7] 张维东, 马长生. 经皮二尖瓣球囊扩张术若干操作技巧[J]. 中华心血管病杂志, 2006, 34:553-554.
[8] Domenech B, Pomar JL, Prat- Gonzalez S, et al. Valvular heart disease epidemics[J]. J Heart Valve Dis, 2016, 25:1-7.
[9] Schotten U,Verheule S, Kirchhof P,et al. Pathophysiological mechanisms of atrial fibrillation: a translational appraisal[J]. Physiol Rev, 2011, 91:265-325.
[10] Gorbaty BJ,Perelman S,Applebaum RM. Left atrial appendage thrombus formation after perioperative cardioversion in the setting of severe rheumatic mitral stenosis[J]. J Cardiothorac Vasc Anesth, 2021, 35:589-592.
[11] He Q, Sze CY, Shum TY,et al. Comparing clinical outcomes of NOACs with warfarin on atrial fibrillation with Valvular heart diseases : a meta- analysis[J]. BMC Cardiovasc Disord, 2019, 19 :113.
[12] Otto CM,Nishimura RA,Bonow RO,et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[J]. J Am Coll Cardiol, 2021, 77:e25-e197.
[13] Gemma D,Moreno Gomez R,Fernandez de Bobadilla J,et al. Percutaneous balloon mitral valvuloplasty and closure of the left atrial appendage: synergy of two procedures in one percutaneous intervention[J]. Rev Port Cardiol, 2016, 35:617.e1- 617.e7.
[14] Gaspardone A,D’Errico F,Iamele M,et al. Single transseptal puncture for left atrial appendage closure and mitral valvuloplasty with total cerebrovascular protection in a patient with acute embolic cerebral ischemia[J]. JACC Cardiovasc Interv, 2018, 11:1302-1306.
[15] Bansal NO,Duggal B,Omnath R. Percutaneous balloon mitral valvuloplasty with bilateral carotid protection in 2 cases of left atrial thrombus[J]. Indian Heart J, 2010, 62:179-180.
[16] 陈君柱,张芙荣,陶谦民,等. 二尖瓣狭窄合并左心房血栓患者的经皮二尖瓣球囊成形术[J]. 介入放射学杂志, 2002, 11:166-168.

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备注/Memo

备注/Memo:
(稿日期:2021- 03-13)
(本文编辑:边 佶)
更新日期/Last Update: 2022-03-17