左心耳封堵术预防心房颤动血栓栓塞单中心经验分析  

Safety and feasibility of left atrial appendage closure device to prevent thrombosis embolism in patients with atrial fibrillation:experience of one center

作　　者：樊友启[1] 杨倩[2] 王建安[1] FAN You-qi YANG Qian WANG Jian-an(Department of Cardiology Ultrasound Department, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China)

机构地区：[1]浙江大学医学院附属第二医院心内科(心脏中心),浙江杭州310009 [2]浙江大学医学院附属第二医院超声科,浙江杭州310009

出　　处：《心脏杂志》2017年第1期16-19,共4页Chinese Heart Journal

摘　　要：目的对中国心房颤动(atrial fibrillation,AF)患者植入WATCHMAN左心耳封堵系统预防血栓栓塞的可行性和安全性进行单中心经验总结。方法入选年龄40~90岁的非瓣膜性AF患者,CHADS2-VAS评分≥2分和HAS-BLED评分≥3分,且不愿意长期口服抗凝药物或口服抗凝药物有禁忌证。经股静脉途径,穿刺房间隔,将WATCHMAN左心耳封堵器输送系统置入左心房,植入WATCHMAN左心耳封堵装置至左心耳颈部。结果入选102例AF患者,年龄(72±9)岁,CHADS2-VAS评分4~7(5.3±1.2)分及HAS-BLED评分3~4(3.4±0.6)分,均成功植入WATCHMAN左心耳封堵系统,手术时间(76±18)min,围手术期及术后2个月随访无出血及栓塞等并发症发生。结论在AF患者中植入WATCHMAN左心耳封堵器预防血栓栓塞是安全可行的。AIM One center experience is presented of the safety and feasibility of implanting the WATCHMAN left atrial appendage closure device at the ostium of the left atrial appendage to prevent thrombosis embolism in patients with atrial fibrillation （AF） in China. METHODS Nonvalvular AF patients between 40 and 90 years of age whose CHADS2-VAS score was≥2 and HAS-BLED score was≥3 were selected. Patients did not want to take long-term oral anticoagulant drugs or had contraindications for the use of oral anticoagulant drugs. The WATCHMAN left atrial appendage closure device delivery system was implanted into the ostium of the left atrial appendage. RESULTS There were 102 AF patients enrolled with an average age of （72 ±9） years, average CHADS2-VAS score （5.3 ± 1.2） and HAS-BLED seore （3.45 ±0. 6）. Average procedural time was （76 ± 18） min. All patients were successfully implanted with the WATCHMAN left atrial appendage closure device. Peri-procedure and after 2 months follow-up, no complications such as bleeding and embolism were found. CONCLUSION We demonstrated the safety and feasibility of implantation of the WATCHMAN left atrial appendage closure device at the ostium of the left atrial appendage to prevent thrombosis embolism in Chinese AF patients.

关 键 词：左心耳封堵术 心房颤动 血栓栓塞 

分 类 号：R541.75[医药卫生—心血管疾病]