左心耳封堵联合房间隔缺损封堵“一站式”治疗对房间隔缺损合并心房颤动患者的安全性及疗效观察  

One-stop treatment of left atrial appendage occlusion combined with closure of atrial septum defect for the patients with atrial septum defect complicated with atrial fibrillation

作　　者：姜小飞 曾杰[3] 卢聪 张恒 朱卫民 JIANG Xiao-fei;ZENG Jie;LU Cong;ZHANG Heng;ZHU Wei-min(Department of Cardiology,Zhuhai People's Hospital,Zhuhai 519000,China;Department of Ultrasound,Zhuhai People's Hospital,Zhuhai 519000,China;Department of Cardiology,Sichuan Provincial People's Hospital,Chengdu 610000,China)

机构地区：[1]珠海市人民医院心内科,广东省珠海市519000 [2]珠海市人民医院超声科,广东省珠海市519000 [3]四川省人民医院心内科

出　　处：《中国心血管病研究》2020年第1期10-14,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨对先天性房间隔缺损合并心房颤动的患者,同期进行经皮左心耳联合房间隔缺损封堵术的可行性、安全性及疗效。方法回顾性分析珠海市人民医院及四川省人民医院2016年1月至2018年6月收治的13例先天性房间隔缺损合并心房颤动的患者的临床资料,术后即刻评价封堵疗效,并于术后45,90 d随访观察左心耳和房间隔封堵器的位置、血栓形成以及残余分流情况及患者临床表现。结果13例患者均成功置入WATCHMAN左心耳封堵器及双盘式房间隔缺损封堵器。术后即刻封堵效果满意,房间隔缺损封堵器封堵器位置满意,固定,无残余分流,WATCHMAN封堵器符合PASS原则,术中无器械表面血栓,无心包压塞及血管并发症。随访结果显示,13例患者无新发卒中未发现心功能恶化、封堵器移位、左心耳封堵器残余分流加重及器械表面血栓。其中1例患者自行转为窦性心律。结论对先天性房间隔缺损合并心房颤动患者,同期实施左心耳联合房间隔缺损封堵术具有操作安全简便的特点,近、中期的随访效果良好。Objective To explore the feasibility,safety and efficacy of one-stop treatment of left atrial appendage occlusion(LAAO)combined with closure of atrial septum defect(ASD)for the patients with atrial septum defect complicated with atrial fibrillation.Methods The clinical data of 13 patients with ASD combined with atrial fibrillation admitted in Zhuhai People's Hospital and Sichuan provincial People's Hospital from January 2016 to June 2018 were retrospectively analyzed.The effects of closure of left atrial appendage(LAA)and ASD were evaluated immediately each time.The location of the occluders of LAA and ASD,thrombosis and residual leak and clinical manifestations were observed during follow-up for 45 days and 90 days.Results 13 patients were successfully implanted with WATCHMANTM device and ASD occluder.After the operation,the immediate sealing effect was satisfactory.The WATCHMANTM occluder was in accordance with the PASS principle and the closure of ASD was satisfactory.During operation,there was no device-related thrombosis,no tamponade and vascular complications.Follow-up results showed that in 13 patients,there was no hemorrhagic stroke,worsening heart function,device dislocation,slubber residual leak and device-related thrombosis as well,angina pectoris or myocardial infarction.One patient turned to sinus rhythm spontaneously and the function of heart became better.Conclusion For patients with non-valvular atrial fibrillation combined with ASD,the safety and feasibility of one-stop treatment with left atrial appendage and ASD can be reliable and the curative effect of short and medium term were also satisfactory.

关 键 词：房间隔缺损 心房颤动 左心耳封堵术 

分 类 号：R541.7[医药卫生—心血管疾病]