兰贝蒂, 杜亚娟, 谢学刚, 何璐, 张松林, 王星烨, 张玉顺. 压缩比偏大WATCHMAN左心耳封堵器的疗效与安全性[J]. 心脏杂志, 2020, 32(3): 257-261. DOI: 10.12125/j.chj.202004068
    引用本文: 兰贝蒂, 杜亚娟, 谢学刚, 何璐, 张松林, 王星烨, 张玉顺. 压缩比偏大WATCHMAN左心耳封堵器的疗效与安全性[J]. 心脏杂志, 2020, 32(3): 257-261. DOI: 10.12125/j.chj.202004068
    shu
    Bei-di LAN, Ya-juan DU, Xue-gang XIE, Lu HE, Song-lin ZHANG, Xing-ye WANG, Yu-shun ZHANG. Effects of different compression ratio on efficacy of WATCHMAN left atrial appendage occluders[J]. Chinese Heart Journal, 2020, 32(3): 257-261. DOI: 10.12125/j.chj.202004068
    Citation: Bei-di LAN, Ya-juan DU, Xue-gang XIE, Lu HE, Song-lin ZHANG, Xing-ye WANG, Yu-shun ZHANG. Effects of different compression ratio on efficacy of WATCHMAN left atrial appendage occluders[J]. Chinese Heart Journal, 2020, 32(3): 257-261. DOI: 10.12125/j.chj.202004068
    shu

    压缩比偏大WATCHMAN左心耳封堵器的疗效与安全性

    Effects of different compression ratio on efficacy of WATCHMAN left atrial appendage occluders

      摘要
    • 摘要:
        目的  观察压缩比偏大WATCHMAN左心耳封堵（left atrial appendage closure, LAAC）术后的短、中期疗效与安全性。
        方法  选择2016年10月～2019年10月我中心实施WATCHMAN左心耳封堵治疗的患者（n=113），按封堵器压缩比≥25%分为压缩比偏大组（n=23）和压缩比正常组(n=90)，研究临床基线资料，统计围手术期并发症的发生情况，随访短、中期情况。
        结果  两组间基线资料的差异无统计学意义。随访中位数14（3,39）月，压缩比偏大组无封堵器表面血栓形成、心脏压塞；无新发脑卒中、外周动脉栓塞；无消化道出血、泌尿系出血以及颅内出血。压缩比偏大组左心耳双叶式形态比例、术中封堵器露肩比例以及术后随访中残余分流比例较压缩比正常组显著增高（P<0.05, P<0.01）。
        结论  压缩比偏大组WATCHMAN LAAC器的短、中期随访结果是安全有效的，但术后残余分流发生率较高。

       

      Abstract:
        AIM  To observe the efficacy and safety of oversized WATCHMAN left atrial appendage (LAA) occluders in patients with non-valvular atrial fibrillation.
        METHODS  Data from patients after implantation of WATCHMAN LAA occluders between October 2016 and October 2019 were analyzed. The patients were divided into oversized group (device compression ratio equal to or greater than 25%) and normal control group. The occurrence of perioperitive and postoperative complications was evaluated.
        RESULTS  A total of 113 patients were included. There were no significant differences in baseline data between the two groups. After a median follow-up period of 14 months (3 to 39 months), there were no complications such as device related thrombosis and cardiac tamponade, no new stroke and peripheral arterial embolism, and no gastrointestinal bleeding, urinary bleeding and intracranial bleeding in oversized group. Compared with those in normal control group, the left atrial appendage bilobal morphology, the exposure shoulder part of occluders and the residual shunt ratio during the postoperative follow-up in oversized group were significantly higher (P <0.05, P <0.01).
        CONCLUSION  The short-to-medium-term follow-up results of oversized WATCHMAN left atrial appendage occluders are safe and effective. However, the incidence of residual shunts after operation is relatively high and the further study should focus on the long-term results in such patients.

       

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