LACBES左心耳封堵器及动物实验可行性研究  

Feasibility study of the use of left atrial appendage occluder LACBES with animal experiment

作　　者：汤学超[1,2] 王飞宇[1] 张志钢[3,4] 阚通 白元[1] 游晓华[1] 黄新苗[1] 许旭东[1] 龚善石 季佳东 秦永文[1] TANG Xue-chao WANG Fei-yu ZHANG Zhi-gang KAN Tong BAI Yuan YOU Xiao-hua HUANG Xin-miao XU Xu-dong GONG Shan-shi JI Jia-dong QIN Yong-wen(Department of Cardiology, Affiliated Changhai Hospital, Second Military Medical University, Shanghai 200433, Chin)

机构地区：[1]第二军医大学附属长海医院心内科,上海200433 [2]解放军第88医院心内科 [3]无锡联勤保障中心 [4]福州总医院心内科 [5]上海普实医疗器械科技有限公司

出　　处：《介入放射学杂志》2017年第1期44-48,共5页Journal of Interventional Radiology

基　　金：国家自然科学基金(81170150)

摘　　要：目的介绍一种自主研究开发的LACBES左心耳封堵器,探讨其封堵左心耳的可行性。方法选取8只健康杂种犬,经股静脉途径应用LACBES封堵器封堵左心耳,术后测量封堵器压缩比例,造影定性评估残余分流;术前术后监测左心房压,分析左心耳封堵后对左心房压的即时影响。结果8只实验犬均成功植入LACBES左心耳封堵器,封堵器压缩比例为10%~15%。1只封堵术后有少量残余分流。2只术后死亡与操作相关,原因分别为封堵器移位及股动脉穿刺部位血肿,无器械相关死亡发生。术后即刻左心房收缩压升高,由术前(25.4±2.8)mm Hg升至(27.5±3.4)mm Hg(P<0.05),15 min后恢复至(25.3±2.8)mm Hg。结论 LACBES封堵器封堵左心耳即刻成功率高,残余分流率低,左心房收缩压短暂升高,器械相关并发症低,有望应用于临床。Objective To introduce a self-developed left atrial appendage occluder, LACBES, and to explore the clinical feasibility of using it for the occlusion of left atrial appendage （LAA）. Methods Eight healthy canines were used in this experimental study. The LAA of each canine was occluded with LACBES occluder through trans-femoral vein approach. After the procedure of occlusion, the compression ratio of the occluder was calculated, the residual shunt was assessed by left atrial angiography. The left atrium pressure was monitored before and after the procedure, and the immediate effect of LAA occlusion on the left atrium pressure was statistically analyzed. Results Implantation of LACBES occluder was successfully accomplished in all the eight canines. The compression ratio of the occluders ranged from 10% to 15%. Small amount of postoperative residual shunt was detected in one canine. After occlusion two canines died of procedure-related complications, including shifting of oceluder and formation of hematoma at puncturing site. No device- associated death occurred. After occlusion, the left atrial systolic pressure increased instantly, which went up from preoperative （25.4±2.8） mmHg to postoperative （27.5±3.4） mmHg （P〈0.05）, but it returned to the baseline of （25.4±2.8） mmHg within 15 minutes. Conclusion For the occlusion of LAA, the use of LACBES oecluder carries higher instant success rate and lower residual shunt rate with less device-associated complications, although the left atrial systolic pressure has a transient rising immediately after the occlusion. Therefore, it is expected that LACBES will be able to be applied in clinical practice.

关 键 词：左心耳封堵器 LACBES封堵器 左心耳封堵术 动物实验 

分 类 号：R541.75[医药卫生—心血管疾病]