局部麻醉下经皮植入国产左心耳封堵器的可行性和安全性观察  

The safety and efficacy of left atrial appendage closure under local anesthesia

作　　者：王彬浩 何斌[1] 傅国华[1] 杜先锋[1] 郁一波[1] 刘晶[1] 丰明俊[1] 储慧民[1] Wang Binhao;He Bin;Fu Guohua;Du Xianfeng;Yu Yibo;Liu Jing;Feng Mingjun;Chu Huimin(Arrhythmia Center,Ningbo First Hospital,Ningbo 315000,China)

机构地区：[1]宁波市第一医院心律失常诊疗中心,315000

出　　处：《中华心律失常学杂志》2019年第5期436-440,共5页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的观察局部麻醉下植入LAmbre左心耳封堵器的安全性及有效性。方法入选2018年2月至8月在宁波市第一医院心内科住院接受经皮左心耳封堵术的22例口服抗凝药治疗相对禁忌或出现不良反应的非瓣膜性心房颤动(房颤)患者,于局部麻醉下经皮植入LAmbre左心耳封堵器。结果共入选22例患者,其中男14例(63.6%)。平均年龄(70.7±9.2)岁,年龄范围51~84岁,CHA2DS2-VASc评分(4.2±1.5)分,HAS-BLED评分(3.2±1.2)分,13例(59.1%)既往脑卒中或短暂性脑缺血发作(TIA)史。所有患者均成功植入LAmbre左心耳封堵器,2例(9.1%)少量残余分流≤3 mm,手术时间及X线曝光时间为(68.7±21.4)min及(8.8±4.7)min,未见手术相关严重并发症。术后45 d复查经食管超声心动图,未发现封堵器移位及封堵器表面血栓,3例(13.6%)少量残余分流≤3 mm。中位随访175 d,未出现血栓栓塞事件。本研究为单组患者可行性及安全性观察,使用合适的统计学方法描述研究结果,无组间比较统计学结果。结论在局部麻醉下经皮植入LAmbre左心耳封堵器是安全、可行的。Objective To investigate the safety and efficacy of percutaneous left atrial appendage closure(LAAC)by Lifetech LAmbre device under local anesthesia.Methods Patients with oral anticoagulation medications contradictions or with related side effects were included in Department of Cardiology,Ningbo First Hospital from February 2018 to August 2018.LAAC was performed using LAmbre device under local anesthesia.This study was a one-arm observational investigation.Appropriate statistical methods were used to describe the results.Therefore,no statistical analysis between groups was performed.Results A total of 22 non-valvular atrial fibrillation patients[64%male,aged(70.7±9.2)years]were consecutively selected.The CHA2DS2-VASc was 4.2±1.5,and the HAS-BLED score was 3.2±1.2.LAmbre device was successfully implanted into all the enrolled patients.The time of procedure and X-ray exposure were(68.7±21.4)min and(8.8±4.7)min,respectively.No thromboembolic events and pericardial effusion occurred.All patients underwent transesophageal echocardiography 45 days post-procedure.Residual flow≤3 mm was found in 3 patients.After a median follow-up period of 175 days,no thromboembolic events occurred.Conclusion LAAC using LAmbre device underlocal anesthesia was safe and effective.

关 键 词：心房颤动 经皮左心耳封堵术 麻醉 局部 

分 类 号：R54[医药卫生—心血管疾病]