心脏CT血管成像评估左心耳封堵术后残余分流的研究进展  

Advances in residual device patency detected by cardiac CT angiography after left atrial appendage closure

作　　者：姚鹏程 费镇涛 李毅刚[1] YAO Peng-cheng;FEI Zhen-tao;LI Yi-gang(Department of Cardiology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院心血管内科,上海200092

出　　处：《中国介入心脏病学杂志》2023年第10期781-787,共7页Chinese Journal of Interventional Cardiology

基　　金：2020年上海市领军人才(049);国家自然科学基金项目(82130009、82070515)。

摘　　要：左心耳封堵术作为心房颤动患者口服抗凝药物的有效且安全替代方式,现已经广泛应用于临床。残余分流,即未完全封堵所致的由左心房进入左心耳的血流,被认为与脑卒中等不良事件相关。心脏CT血管成像可敏感地探查到残余分流,且除了封堵器周围漏外还可以发现封堵器未完全内皮化的现象。本文综述了心脏CT血管成像在评估左心耳封堵术后残余分流方面的优势及其影像上左心耳封堵术后残余分流的分类、发生率与临床预后相关性。Percutaneous left atrial appendage closure,as a feasible and safe alternative to oral anticoagulants for patients with atrial fibrillation,has been widely used in clinical practice.Residual device patency,which means continuous blood flowing from left atrium to left atrial appendage due to incomplete closure,is considered to be associated with adverse events,such as ischemic stroke.Cardiac CT angiography can sensitively detect residual patency,including peri-device leak and incomplete device endothelialization.This review focuses on the difference of device surveillance on residual patency after left atrial appendage closure,together with the classification,incidence rate of patency detected by cardiac CT angiography and its relevance with clinical outcomes.

关 键 词：心房颤动 左心耳封堵术 残余分流 心脏CT血管成像 缺血性脑卒中 

分 类 号：R541.7[医药卫生—心血管疾病]