左心耳封堵术(LAAC)用于接受其他心脏介入手术治疗的心房纤颤(房颤)患者的安全性及可行性分析

Safety and Feasibility of Left Atrial Appendage Occlusion(LAAC) in Patients with Atrial Fibrillation(AF) Undergoing Other Cardiac Interventional Procedures

目的分析左心耳封堵术(LAAC)用于接受其他心脏介入治疗的心房纤颤(房颤)患者的安全性及可行性。方法方便选取2016年1月-2018年6月期间该院接收的18例心房纤颤患者作为研究对象,所有患者均在进行左心耳封堵术进行治疗时,接受其他心脏介入手术治疗,观察并分析患者经过治疗后的临床效果和安全性。结果 18例患者左心耳封堵术均手术成功,其中左心耳最大直径为17~29 cm,封堵器直径为27~35 mm,封堵器压缩比为16.5%~32.9%,封堵器与推送杆完全解离后仅发现1例患者封堵器附近出现残余分流(3 mm),剩余17例均未出现残余分流;同时,经过术后随访,18例患者均未出现任何出血情况和动脉栓塞事件。结论心房纤颤患者在接受导管主动脉瓣置换术、经皮冠状动脉介入以及心导管射频消融术心脏介入手术治疗时,予以左心耳封堵术,能够有效改善患者临床症状,控制患者术后出血与动脉栓塞等不良事件的发生,具有可行性与安全性。

Objective To analyze the safety and feasibility of left atrial appendage occlusion(LAAC) in patients with atrial fibrillation(AF) undergoing other cardiac interventions. Methods Eighteen patients with atrial fibrillation received in the hospital from January 2016 to June 2018 were conveniently selected as the study subjects. All patients received other interventional cardiac surgery during the treatment of left atrial appendage occlusion. The clinical effect and safety of the patients after treatment were observed and analyzed. Results All 18 patients were successfully operated. The maximum diameter of left atrial appendage was 17-29 cm, the diameter of occluder was 27-35 mm, and the compression ratio of occluder was 16.5%-32.9%. Only one patient had residual shunt(3 mm) near the occluder after the occluder and push rod were completely removed. No residual shunt was found in the remaining 17 patients. At the same time, after follow-up, no bleeding or arterial embolism occurred in 18 patients. Conclusion The left atrial appendage occlusion in patients with atrial fibrillation undergoing catheter aortic valve replacement, percutaneous coronary intervention and cardiac catheter radiofrequency ablation can effectively improve the clinical symptoms of patients and control the occur rence of adverse events such as bleeding and arterial embolism.