LAmbre封堵器封堵左心耳后密封盘周围漏与封堵器相关血栓发生的关系

The correlation between peridevice leak and device-related thrombus after left atrial appendage closure with LAmbre occluder

目的探讨心房颤动(房颤)患者左心耳植入LAmbre封堵器后密封盘周围漏与封堵器相关血栓(DRT)发生的关系。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封堵器封堵左心耳治疗并完成经食管超声心动图复查的137例房颤患者,比较不同型号LAmbre封堵器植入后密封盘周围漏和DRT发生情况。结果137例患者年龄为(74.9±9.2)岁,>80岁(80~93岁)患者占40.1%,女性占38.7%,房颤血栓栓塞风险(CHA_(2)DS_(2)-VASc)评分、抗凝治疗出血风险评估(HAS-BLED)评分分别为(5.6±1.9)分、(2.7±1.6)分。左心耳植入LAmbre封堵器后1~3 mm密封盘周围漏最常见,仅1例植入3640型LAmbre患者密封盘周围漏为6 mm。比较植入不同型号封堵器后密封盘周围漏发生率,差异无统计学意义(P>0.05)。封堵盘周围漏与DRT发生无相关性。结论心房颤动左心耳植入LAmbre封堵器后1~3 mm密封盘周围漏发生最常见,不同型号LAmbre封堵器间密封盘周围漏与DRT发生负相关。

Objective To investigate the correlation between peridevice leak and LAmbre occluder device-related thrombus(DRT)in atrial fibrillation(AF)patients after receiving left atrial appendage closure(LAAC)by using LAmbre occluder.Methods The clinical data of 137 patients with AF,whom received LAAC by using LAmbre occluder at Shanghai Zhoupu Hospital of China between May 2018 and June 2021 and completed transesophageal echocardiography reexamination,were retrospectively analyzed.The occurrences of peridevice leak and DRT were compared between different types of LAmbre occluder.Results The mean age of the 137 AF patients was(74.9±9.2)years,38.7%of patients were females and 40.1%of patients were≥80 years(80-93 years).The risk of thromboembolism in AF(CHA_(2)DS_(2)-VASC)score and bleeding risk of anticoagulation therapy(HAS-BLED)score were(5.6±1.9)points and(2.7±1.6)points respectively.After implantation of LAAC,the peridevice leak of 1-3 mm was most commonly seen,only in one patient,whom receiving LAmbre occluder of type 3640,a peridevice leak of 6 mm occurred.No statistically significant difference in the incidence of peridevice leak existed between different types of LAmbre occluder(P>0.05).There was no correlation between the leakage around the blocking disc and the DRT.The peridevice leak bore no relationship to the occurrence of DRT.Conclusion The peridevice leak of 1-3 mm is most commonly seen in AF patients after receiving implantation of LAmbre occluder.The peridevice leak of different types of LAmbre occluder bears no relationship to the occurrence of DRT.