Watchman左心耳封堵器的临床应用

发布时间：2018-04-18 17:23

本文选题：心房颤动 + 左心耳封堵　；参考：《第三军医大学学报》2014年20期

【摘要】：目的通过应用Watchman左心耳封堵器对非瓣膜病房颤患者左心耳进行封堵治疗,评价左心耳封堵效果与安全性。方法收集我院近期完成的应用Watchman左心耳封堵器进行左心耳封堵的临床资料,总结分析其基线资料,左心耳测量数据(心脏超声及造影)以及介入操作结果。结果 12例行左心耳封堵术治疗患者全部成功(成功率100%),其中男性6例、女性6例,年龄51~81(66.4±14.5)岁,房颤病史0.5~7(2.78±4.12)年。12例患者CHA2DS2-VASc评分为2~6(4.1±1.9)分。术中TEE测量左心耳开口最大直径为(19.7±2.2)mm;左心耳造影图像测得左心耳开口最大直径为(20.1±2.3)mm;两种方法测量的左心耳开口直径无显著差异(P0.05)。所用12枚Watchman封堵器直径(25.0±3.2)mm;植入左心耳内后TEE测量封堵器最大直径(20.3±5.8)mm,压缩率为(22.1±3.9)%。6例患者封堵后有少量残余分流,无手术相关并发症。结论应用Watchman左心耳封堵器进行左心耳封堵是安全、有效的,但需严格把握适应证,遵循严格的操作规范。
[Abstract]:Objective to evaluate the efficacy and safety of left atrial appendage occlusion (LASA) in patients with non-valvular fibrillation by using Watchman occluder.Methods the clinical data of left atrial appendage occlusion with Watchman occluder were collected, and the baseline data, left atrial appendage measurement data (echocardiography and echocardiography) and the results of interventional operation were summarized and analyzed.Results all the 12 patients were successfully treated with left atrial appendage closure (success rate was 100%). The CHA2DS2-VASc score of 12 patients with atrial fibrillation was 64.1 卤1.9, 66.4 卤14.5 years old and 64.1 卤1.9years old, respectively. The clinical history of atrial fibrillation was 0.5 ~ 72.78 卤4.12 years.The maximum diameter of left atrial auricle was 19.7 卤2.2 mm measured by TEE and 20.1 卤2.3 mm by left atrial appendage imaging. There was no significant difference in the diameter of left atrial appendage between the two methods.The diameter of 12 Watchman occluders was 25.0 卤3.2mm. the maximum diameter of the occluder was 20.3 卤5.8mm and the compression ratio was 22.1 卤3.9mm. there was a little residual shunt after occlusion, and there were no operative complications.Conclusion it is safe and effective to use the Watchman occluder to occlude the left atrial appendage, but it is necessary to strictly grasp the indications and follow the strict operation rules.
【作者单位】：第三军医大学西南医院心内科重庆市介入治疗研究所;第三军医大学西南医院超声诊断科;
【分类号】：R197.39

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