影像学在左心耳封堵中的意义

Cardiac Imaging for Left Atrial Appendage Occlusion

心房颤动患者的卒中风险显著增加,左心耳封堵术作为抗凝药物的替代手术方式,可降低心房颤动患者的卒中风险,目前已在世界范围内广泛开展。左心耳封堵术的成功实施很大程度上依赖各种影像学手段进行术前术后评估以及术中引导。这些成像方式主要包括:经食管心脏超声、心脏CT、血管造影、心脏磁共振及心腔内超声。近年来,三维成像技术进一步提升了术者对心脏解剖结构的理解。现总结各类影像学检测手段在左心耳封堵术中应用的最新证据,为临床工作的开展提供参考。

Patients with atrial fibrillation has significantly increasing stroke risks. Left atrial appendage occlusion(LAAO), as an alternative to oral anticoagulants, can reduce the risk of stroke, which has been widely conducted worldwide. Imaging approach is often used for preoperative assessment, procedural guidance and postoperative evaluation, which is the key of successful LAAO. These imaging modalities include transesophageal echocardiography, cardiac computed tomography, angiography, cardiac magnetic resonance, and intracardiac echocardiography. Recently, three-dimensional techniques allow a better understanding of cardiac anatomy. This review updated the recent evidence of imaging modalities application in LAAO to offer some help for clinical work.