对比盘式封堵器LAmbre与LAcbes封堵左心耳治疗心房颤动

Comparison on lobe-and-disc devices LAmbre and LAcbes in left atrial appendage colsure for treating atrial fibrillation

目的对比以盘式封堵器LAmbre与LAcbes行左心耳封堵(LAAC)治疗心房颤动(AF)的有效性和安全性。方法分析99例接受以LAcbes封堵器(LAcbes组)、130例以LAmbre封堵器(LAmbre组)行LAAC的AF患者,对比治疗效果、安全性及预后。结果LAcbes组左心耳完全封堵率66.67%(66/99),LAmbre组57.69%(75/130),组间差异无统计学意义(P>0.05)。LAcbes组密封盘直径、固定盘直径及封堵术后周边漏(特别是1~3 mm周边漏)发生率均低于LAmbre组(P均<0.01)。2组围术期均无急性心脏压塞及死亡病例。术后(中位复查时间为术后72天)复查经食管超声心动图,组间器械相关血栓发生率差异无统计学意义(P>0.05)。术后平均随访(12±6)个月,随访期间LAcbes组5例(5/99,5.05%)、LAmbre组1例(1/130,0.77%)发生延迟性心脏压塞,LAcbes组发生脑梗死、短暂性缺血发作各1例,LAmbre组发生脑梗死2例、脑出血1例、死于心力衰竭1例,2组差异均无统计学意义(P均>0.05)。结论盘式封堵器LAmbre与LAcbes封堵左心耳治疗AF的效果及安全性均相当。

Objective To compare the efficacy and safety of left atrial appendage colsure(LAAC)with lobe-and-disc devices,LAmbre and LAcbes for treatment of atrial fibrillation(AF).Methods Data of 99 AF patients underwent LAAC using LAcbes(LAcbes group)and 130 using LAmbre(LAmbre group)were retrospectively analyzed,and the efficacy,safety and prognosis were compared between groups.Results The complete occlusion rate in LAcbes and LAmbre group was 66.67%(66/99)and 57.69%(75/130),respectively,there was no significant different between groups(P>0.05).The diameter of the sealing disc,fixed disc and the incidence of peridevice leak(especially 1—3 mm)in LAcbes group were lower than those in LAmbre group(all P<0.01).There was neither acute cardiac tamponade nor death occurred during perioperative period.Postoperative transesophageal echocardiography was performed after LAAC(median time internal of 72 days),and no significant difference of the incidence of device related thrombus was found between groups(P>0.05).During(12±6)months'following-up,5 cases(5/99,5.05%)in LAcbes group and 1 case(1/130,0.77%)in LAmbre group developed delayed cardiac tamponade.One case occurred cerebral infarction and 1 case occurred transient ischemic attack in LAcbes group,while 2 cases developed cerebral infarction,1 case developed cerebral hemorrhage and 1 case died of heart failure in LAmbre group.There was no significant difference between groups(all P>0.05).Conclusion Lobe-and-disc devices LAmbre and LAcbes had similar efficacy and safety in LAAC for treating AF.