Watchman左心耳封堵术在地市级医院单中心运用的初步研究  

The preliminary application of left atrial appendage closure with Watchman device in a municipal hospital

作　　者：刘龙斌[1] 彭放[1] 杨芳芳[1] 裘宇芳[1] 鲁建新[2] 陈忠华[3] 韩敏[4] 郭航远[1] 

机构地区：[1]浙江省绍兴市人民医院(浙江大学绍兴医院)心内科,312000 [2]浙江省绍兴市人民医院(浙江大学绍兴医院)超声科,312000 [3]浙江省绍兴市人民医院(浙江大学绍兴医院)麻醉科,312000 [4]浙江省绍兴市人民医院(浙江大学绍兴医院)放射科,312000

出　　处：《心电与循环》2016年第2期94-97,共4页Journal of Electrocardiology and Circulation

摘　　要：目的：评价Watchman左心耳封堵术在地级市医院应用的可行性和安全性。方法选取2015年2月至2015年10月因口服抗凝药物有禁忌证或不愿意长期口服抗凝药物的非瓣膜性心房颤动患者11例，其中男性7例，女性4例，年龄52-80（68.55±8.97）岁；CHA2DS2- VAS评分2-7分；HAS- BLED评分3-6分。采用全身静脉麻醉或局部麻醉＋深度镇静，食管B超及X线透视指导下，将Watchman左心耳封堵器释放于左心耳颈部。结果其中10例患者成功植入Watchman左心耳封堵器，1例患者因左心耳颈过大，未行左心耳封堵术。围手术期及术后最长10个月随访期间均无出血、心包压塞、封堵器脱落及栓塞等并发症发生。结论在条件成熟的地市级医院开展Watchman左心耳封堵术是安全可行的。Objective To evaluate the feasibility and safety of left atrial appendage closure with Watchman device in a municipal hospital. Methods 11 non- valvular atrial fibril ation patients（7 male, age 18 to 80 years ） with CHA2DS2- VAS score≥2 and HAS- BLED score≥3 underwent Watchman closure device implantation for contraindications of oral anticoagulant drugs or unwil ing to take oral anticoagulant drugs in long term prevention. Watchman closure device was released at the ostium of the left atrial appendage guided by transesophageal echocardiography and X- ray fluoroscopy under general anesthesia or local anesthesia and deep sedation. Results The procedure was successful in 10 patients. One case was not performed for a large left atrial appendage ostium. No complications of bleeding, cardiac tamponade, closure device drop out and embolism occurred during perioperative period and fol ow- up 10 months. Conclusion The procedure of left atrial appendage closure with Watchman device is safety and feasibility in a conditional municipal hospital.

关 键 词：Watchman封堵器 左心耳 封堵术 

分 类 号：R541.75[医药卫生—心血管疾病]