经食管超声心动图引导以LAmbre封堵器封堵左心耳  

Transesophageal echocardiography for guiding left atrial appendage closure with LAmbre occluder

作　　者：张萌 何文[1] 杜丽娟[1] 兰亭玉 吕一飞 张惠琴[1] 段凤霞[1] 张巍[1] ZHANG Meng;HE Wen;DU Lijuan;LAN Tingyu;LYU Yifei;ZHANG Huiqin;DUAN Fengxia;ZHANG Wei(Department of Ultrasound,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院超声科,北京100070

出　　处：《中国医学影像技术》2024年第2期177-181,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察经食管超声心动图(TEE)引导以LAmbre封堵器行左心耳封堵(LAAC)的价值。方法回顾性分析40例接受以LAmbre封堵器行LACC的非瓣膜性心房颤动(NVAF)患者,对比治疗前CT血管造影(CTA)、治疗中TEE及数字减影血管造影(DSA)所见,分析其所测锚定区直径和左心耳开口直径与封堵器型号的相关性,以及TEE与DSA评估封堵器周围漏(PDL)的差异。结果40例均成功植入LAmbre封堵器。固定伞直径与CTA、TEE及DSA所测锚定区直径均呈正相关(r=0.79、0.82、0.91,P均<0.01);封堵伞直径与CTA、TEE及DSA所测左心耳开口直径均呈正相关(r=0.56、0.89、0.86,P均<0.01)。LAAC中释放封堵器后即刻16例出现PDL,TEE和DSA均可检出;24例TEE及DSA均未见PDL。结论TEE用于引导以LAmbre封堵器行LAAC的价值与DSA相当。Objective To observe the value of transesophageal echocardiography(TEE)for guiding left atrial appendage closure(LAAC)with LAmbre occluder.Methods Data of 40 non-valvular atrial fibrillation(NVAF)patients who underwent LAAC with LAmbre occluder were retrospectively analyzed.CT angiography(CTA)before treatment,TEE and digital subtraction angiography(DSA)findings during LAAC were comparatively observed,and the correlations of the anchor area diameter and left atrial appendage opening diameter measured with the above three as well as occluder size were analyzed,and TEE and DSA for evaluating peri-device leak(PDL)were compared.Results LAAC were successfully performed with LAmbre occlude in all 40 cases.The diameter of the fixed umbrella was positively correlated with anchor area diameter measured with CTA,TEE and DSA(r=0.79,0.82,0.91,all P<0.01),of occlusion umbrella was positively correlated with left atrial appendage opening diameter measured with CTA,TEE and DSA(r=0.56,0.89,0.86,all P<0.01).Immediately after the release of occluder in LAAC,PDL occurred in 16 cases and were detected with both TEE and DSA,while in the rest 24 cases no PDL was found with neither TEE nor DSA.Conclusion TEE had comparable value to DSA for guiding LAAC using LAmbre occluder.

关 键 词：心房颤动 间隔封堵器 超声检查 左心耳 

分 类 号：R541.75[医药卫生—心血管疾病] R540.45[医药卫生—内科学]