LAmbre封堵器在大口部直径左心耳封堵术中的可行性和安全性初探  

Feasibility and safety of closing large left atrial appendage using the LAmbre device

作　　者：郁一波[1] 傅国华[1] 卓伟东 王彬浩 储慧民[1] Yu Yibo;Fu Guohua;Zhuo Weidong;Wang Binhao;Chu Huimin(Arrhythmia Center,Ningbo First Hospital,Ningbo 315010,China;Ningbo University School of Medicine,Ningbo 315211,China)

机构地区：[1]宁波市第一医院心律失常诊疗中心,宁波315010 [2]宁波大学医学院,宁波315211

出　　处：《中华心血管病杂志》2022年第8期780-784,共5页Chinese Journal of Cardiology

摘　　要：目的初步评估LAmbre封堵器在大口部直径左心耳封堵术中的可行性和安全性。方法本回顾性队列研究选取2018年6月至2020年3月在宁波市第一医院心律失常诊疗中心接受经皮置入LAmbre左心耳封堵器,且左心耳口部直径≥31 mm的非瓣膜性心房颤动患者。收集患者的基线资料并记录左心耳封堵术围术期主要并发症(包括死亡、卒中、器械栓塞、心包填塞及主要出血事件等)。术后45 d、6及12个月进行随访,经食道心脏超声或肺静脉CT记录封堵器边缘分流及器械相关血栓情况,并记录术后血栓栓塞、出血事件及死亡等严重不良事件发生情况。结果共纳入32例患者,年龄(70.4±8.4)岁,女性12例(37.5%),左心耳口部直径(34.4±2.9)mm。31例(96.9%)成功置入LAmbre封堵器。围术期未出现主要并发症。术后12个月的随访中,1例(3.2%)患者出现心包填塞,经治疗后好转。经食道心脏超声随访的患者中未出现封堵器边缘分流>5 mm,所有患者未出现器械相关血栓以及血栓栓塞、出血事件和严重不良事件。结论LAmbre封堵器在大口部直径左心耳封堵术中可能是可行、安全的。Objective To evaluate the feasibility and safety of the LAmbre occluder for large-diameter left atrial appendage occlusion.Methods This study was a retrospective cohort study.Patients with large orifice of the left atrial appendage(≥31 mm)and occlusion with the LAmbre device in the Arrhythmia Center of Ningbo First Hospital were included from June 2018 to March 2020.Baseline data were collected and major perioperative complications of left atrial appendage occlusion(including death,stroke,instrumental embolism,cardiac tamponade,and major bleeding events)were recorded.Patients were followed up 45 days,6 months and 12 months after surgery.The shunt and device-related thrombosis were recorded by esophageal cardiac ultrasound or pulmonary vein CT,and the occurrence of postoperative thromboembolism,bleeding events,death and other serious adverse events were recorded.Results The average age and left atrial appendage ostial dimension of 32 patients(37.5%women)included in this research were(70.4±8.4)years old and(34.4±2.9)mm.The LAmbre device was successfully implanted in 31(96.9%)patients.No major complications occurred during the perioperative period.During the 12-month follow-up,pericardial tamponade occurred in 1(3.2%)patient and was recovered after treatment.There was no occluder edge shunt>5 mm in patients followed up by esophageal echocardiography.No significant peri-device leak,device-related thrombus,thromboembolism or death event has occurred.Conclusion The LAmbre occluder may be feasible and safe for large-diameter left atrial appendage occlusion.

关 键 词：心房颤动 经皮左心耳封堵术 LAmbre封堵器 左心耳大口部直径 

分 类 号：R541.75[医药卫生—心血管疾病]