Cryoballoon pulmonary vein isolation and left atrial appendage occlusion prior to atrial septal defect closure: A case report  

作　　者：Yu-Cheng Wu Mei-Xiang Wang Ge-Cai Chen Zhong-Bao Ruan Qing-Qing Zhang 

机构地区：[1]Department of Cardiology,Taizhou People’s Hospital,Taizhou 225300,Jiangsu Province,China [2]Department of Endocrinology,Taizhou People’s Hospital,Taizhou 225300,Jiangsu Province,China

出　　处：《World Journal of Clinical Cases》2022年第12期3872-3878,共7页世界临床病例杂志

基　　金：Supported by Taizhou People’s Hospital Scientific Research Start-Up Fund Project,No. QDJJ202113

摘　　要：BACKGROUND In patients who suffer from both atrial fibrillation(AF)and atrial septal defect(ASD),cryoballoon pulmonary vein isolation(PVI),sequential left atrial appendage(LAA)occlusion and ASD closure could be a strategy for effective prevention of stroke and right heart failure.CASE SUMMARY A 65-year-old man was admitted to our institution due to recurrent episodes of palpitations and shortness of breath for 2 years,which had been worsening over the last 48 h.He had a history of AF,ASD,coronary heart disease with stent implantation and diabetes.Physical and laboratory examinations showed no abnormalities.The score of CHA2DS2VASc was 3,and HAS-BLED was 1.Echocardiography revealed a 25-mm secundum ASD.Pulmonary vein(PV)and LAA anatomy were assessed by cardiac computed tomography.PV mapping with 10-pole Lasso catheter was performed following ablation of all four PVs with complete PVI.Following the cryoballoon PVI,the patient underwent LAA occlusion under transesophageal echocardiographic monitoring.Lastly,a 34-mm JIYI ASD occlude device was implanted.A follow-up transesophageal echocardiography at 3 mo showed proper position of both devices and neither thrombi nor leakage was found.CONCLUSION Sequential cryoballoon PVI and LAA occlusion prior to ASD closure can be performed safely in AF patients with ASD.

关 键 词：Atrial fibrillation Atrial septal defect CRYOBALLOON Pulmonary vein isolation Left atrial appendage occlusion Case report 

分 类 号：R541.75[医药卫生—心血管疾病]