[1]王赛华,郇 强,郝舒文,等.盘式封堵器封堵老年心房颤动患者大口径左心耳的安全性和有效性[J].介入放射学杂志,2022,31(10):958-961.
 WANG Saihua,HUAN Qiang,HAO Shuwen,et al.The safety and effectiveness of disc-type occluder in occluding large-diameter left atrial appendage in elderly patients with atrial fibrillation[J].journal interventional radiology,2022,31(10):958-961.
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盘式封堵器封堵老年心房颤动患者大口径左心耳的安全性和有效性()

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

卷:
31
期数:
2022年10
页码:
958-961
栏目:
心脏介入
出版日期:
2022-11-07

文章信息/Info

Title:
The safety and effectiveness of disc-type occluder in occluding large-diameter left atrial appendage in elderly patients with atrial fibrillation
作者:
王赛华 郇 强 郝舒文 罗 俊 武英彪 朱 茜 方 明 田 蓓 顾 薇 宋 湘 宁忠平 赵志宏
Author(s):
WANG Saihua HUAN Qiang HAO Shuwen LUO Jun WU Yingbiao ZHU Qian FANG Ming TIAN Bei GU Wei SONG Xiang NING Zhongping ZHAO Zhihong.
Department of Cardiology, Affiliated Zhoupu Hospital, Shanghai University of Medicine & Health Sciences,Shanghai 201318, China
关键词:
【关键词】 心房颤动 盘式封堵器 左心耳封堵术 不良事件
文献标志码:
A
摘要:
【摘要】 目的 评价盘式封堵器应用于老年心房颤动(房颤)患者大口径左心耳的安全性和有效性。方法 回顾性分析2018年5月至2021年6月在上海周浦医院接受LAmbre盘式封堵器封堵术治疗的老年房颤患者临床资料。78例左心耳开口直径≥31 mm患者为大口径组,140例左心耳开口直径<31 mm患者为非大口径组。比较两组患者临床一般资料、术中参数、抗栓治疗方案及随访12(10,22)个月结果。 结果 大口径组女性占42.3%,年龄(75.8±9.1)岁,≥80岁患者比例为43.6%。大口径组盘式封堵器密封盘直径范围为32~40 mm,术后封堵器周边漏发生率显著高于非大口径组(P<0.05);器械相关血栓(DRT)发生率为13.3%(8/60),高于非大口径组4.2%(4/96)(P<0.05)。两组术后发生脑梗死、短暂性脑缺血发作、脑出血及死亡差异无统计学意义(均P>0.05)。 结论 老年大口径左心耳房颤患者接受盘式封堵器封堵治疗安全有效,术后封堵器周边漏及DRT发生率增加,但不影响临床预后。

参考文献/References:

[1] 中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2020概要[J]. 中国循环杂志, 2021, 36:521-545.
[2] 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,等. 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.
[3] Munir MB, Khan MZ, Darden D, et al. Contemporary procedural trends of Watchman percutaneous left atrial appendage occlusion in the United States[J]. J Cardiovasc Electrophysiol, 2021, 32: 83-92.
[4] 王光记,孔 彬,黄 鹤. 国产左心耳封堵器预防心房颤动患者脑卒中的研究进展[J]. 中华心律失常学杂志, 2020, 24:611- 613.
[5] So CY, Li S, Fu GH, et al. Procedural and short-term outcomes of occluding large left atrial appendages with the LAmbre device[J]. EuroIntervention, 2021, 17: 90-92.
[6] Narasimhan B, Aedma SK, Bhatia K, et al. Current practice and future prospects in left atrial appendage occlusion[J]. Pacing Clin Electrophysiol, 2021, 44: 1236-1252.
[7] 赵志宏,王赛华,宋 湘,等. 85岁及以上心房颤动患者左心耳Watchman封堵疗效分析[J]. 中华老年医学杂志, 2022, 41:11-14.
[8] 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.
[9] 赵志宏,王赛华,罗 俊,等. 心房颤动患者左心耳LAmbre封堵术后器械相关血栓发生及转归分析[J]. 介入放射学杂志, 2022, 31:130-134.
[10] 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,中国房颤中心联盟心房颤动防治专家工作委员会. 心房颤动:目前的认识和治疗建议(2021)[J]. 中华心律失常学杂志, 2022:15-88.
[11] Schmidt B, Bordignon S, Chen S, et al. What does the future hold?:Ideal device, newer devices, and more[J]. Card Electrophysiol Clin, 2020, 12: 125-130.
[12] Saad M, Risha O, Sano M, et al. Comparison between amulet and watchman left atrial appendage closure devices: a real-world, single center experience[J]. Int J Cardiol Heart Vasc, 2021, 37: 100893.
[13] Park JW, Sievert H, Kleinecke C, et al. Left atrial appendage occlusion with lambre in atrial fibrillation: initial European experience[J]. Int J Cardiol, 2018, 265: 97-102.
[14] 黄 鹤,刘 育,杨 波,等. 经皮左心耳封堵预防心房颤动血栓栓塞一例[J]. 中国心脏起搏与心电生理杂志, 2014, 28:77-78.
[15] Schnupp S, Ajmi I, Brachmann J, et al. Lifetech LAmbre: a new promising and novel device in the interventional stroke prevention[J]. Future Cardiol, 2019, 15: 405-410.
[16] Ali M, Rigopoulos AG, Mammadov M, et al. Systematic review on left atrial appendage closure with the LAmbre device in patients with non-valvular atrial fibrillation[J]. BMC Cardiovasc Disord, 2020, 20: 78.
[17] 赵志宏,郇 强,丛新鹏,等. 心房颤动Watchman封堵失败后再置入LAmbre封堵器一例[J]. 中华老年心脑血管病杂志, 2021, 23:1325-1326.
[18] So CY, Lam YY, Cheung GS, et al. Occlusion of a multilobed shallow left atrial appendage using a special LAmbre device after failed watchman implantation[J]. J Invasive Cardiol, 2019, 31: E41-E42.
[19] Cruz-Gonzalez I, Nunez JC, Diaz-Pelaez E. Double LAmbre occlusion technique for extra-large and shallow left atrial appendage[J]. Rev Esp Cardiol(Engl Ed), 2020, 73:1061.
[20] So CY, Leung KF, Lam YY, et al. Occlusion of an extremely large left atrial appendage using the “Double-LAmbre Technique”[J]. JACC Cardiovasc Interv, 2019, 12: 1085-1087.
[21] Piayda K, Sievert K, Della Rocca DG, et al. Safety and feasibility of peri-device leakage closure after LAAO: an international, multicentre collaborative study[J]. EuroIntervention, 2021, 17: e1033-e1040.
[22] Jang SJ, Wong SC,Mosadegh B. Leaks after left atrial appendage closure: ignored or neglected?[J]. Cardiology, 2021, 146:384-391.
[23] Alkhouli M, Du C, Killu A, et al. Clinical impact of residual leaks following left atrial appendage occlusion: insights from the NCDR LAAO registry[J]. JACC Clin Electrophysiol, 2022, 8:766-778. [24] Wang G, Kong B, Qin T, et al. Incidence, risk factors, and clinical impact of peridevice leak following left atrial appendage closure with the LAmbre device-data from a prospective multicenter clinical study[J]. J Cardiovasc Electrophysiol, 2021, 32: 354-359.

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备注/Memo

备注/Memo:
(收稿日期:2022-04-03)
(本文编辑:边 佶)
更新日期/Last Update: 2022-11-02