郭雪原, 马长生. 左心耳封堵策略选择[J]. 心脏杂志, 2017, 29(1): 4-006.
    引用本文: 郭雪原, 马长生. 左心耳封堵策略选择[J]. 心脏杂志, 2017, 29(1): 4-006.
    Left atrial appendage occlusion as a therapeutic strategy for atrial fibrillation[J]. Chinese Heart Journal, 2017, 29(1): 4-006.
    Citation: Left atrial appendage occlusion as a therapeutic strategy for atrial fibrillation[J]. Chinese Heart Journal, 2017, 29(1): 4-006.

    左心耳封堵策略选择

    Left atrial appendage occlusion as a therapeutic strategy for atrial fibrillation

    • 摘要: 心房颤动是临床上最常见的心律失常之一,血栓栓塞并发症是其致残、致死的主要原因。经食管超声检查发现,非瓣膜性房颤患者心房内血栓90%位于左心耳。因此,预防左心耳血栓形成可能会减少血栓栓塞事件的发生。口服抗凝药是预防房颤血栓栓塞并发症的有效方法,但是很多患者不能耐受口服抗凝药药物治疗。随着心血管介入治疗和器械研发的进展,经皮左心耳封堵预防卒中越来越受到关注,已经成为一种替代华法林预防房颤并发卒中的有效方法。

       

      Abstract: Atrial fibrillation (AF) is one of the most common arrthymias. AF places patients at increased risk of thromboembolism, in particular ischemic stroke. The left atrial appendage (LAA) is a site of major blood stasis during AF, increasing the risk of thrombus formation and stroke; 90% of thrombus formation in nonvalvular AF is in the LAA. Therefore, percutaneous LAA exclusion is an evolving treatment to prevent embolic events in patients with nonvalvular AF. Oral anticoagulation (OAC) has been shown to significantly reduce the risk of thromboembolism in numerous studies. Traditional OAC, such as warfarin, has many limitations including constant monitoring, slow onset and offset of action, inter-individual variability in anticoagulant effect, narrow therapeutic index, and food and drug interactions. Therefore, closure of the LAA might provide an alternative strategy to chronic warfarin therapy for stroke prophylaxis in patients with non-valvular atrial fibrillation.

       

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