先天性心脏病合并心房颤动经皮左心耳与缺损同期封堵的一站式治疗

Simultaneous occlusion of congenital heart disease with atrial fibrillation followed by percutaneous left atrial appendage closure

先天性心脏病(简称先心病)血流动力学变化使心脏电解剖结构改变易引起心房颤动(简称房颤)。随着介入及外科技术的发展,临床上已有多种治疗策略应用于先心病合并房颤一站式治疗。为预防房颤致脑卒中,转复窦律后房颤复发率高,而口服抗凝药物达标率低或出血风险高,均不是理想的一站式治疗策略。先心病伴房颤患者行左心耳封堵术,并同期一站式先心病介入封堵治疗成为新热点,短中期随访显示该技术可行、安全、有效,远期疗效仍需进一步深入研究。

The changes of hemodynamics in congenital heart disease make the variety of cardiac electroanatomical structure be easily to cause atrial fibrillation.With the development of interventional and surgical techniques,different therapeutic strategies had been applied to simultaneous treatment of atrial septal defect with atrial fibrillation.In order to prevent stroke caused by atrial fibrillation,the recurrence rate of atrial fibrillation after electrical cardioversion was high,while oral anticoagulants with low control rate or high risk of bleeding which were not ideal simultaneous treatment strategies.Left atrial appendage occlusion in congenital heart disease patients with atrial fibrillation,and simultaneous interventional occlusion therapy for congenital heart disease,had become a new research focus.Short and medium term follow-up showed that this technique was feasible,safe and effective,and yielded to further study.