非瓣膜性心房颤动患者DSA指导下极简式经皮植入WATCHMAN FLX左心耳封堵器的效果观察  

The efficacy of minimalist percutaneous implantation of WATCHMAN FLX left atrial appendage closure guided by DSA in patients with non-valvular atrial fibrillation: an observational study

作　　者：费晓红 孙一钧 王彬浩 傅国华 丰明俊[1] 郁一波[1] 杜先锋 储慧民[1] FEI Xiaohong;SUN Yijun;WANG Binhao;FU Guohua;FENG Mingjun;YU Yibo;DU Xianfeng;CHU Huimin(Arrhythmia Center,the First Affiliated Hospital of Ningbo University,Ningbo 315000,China)

机构地区：[1]宁波大学附属第一医院心律失常诊疗中心,315000

出　　处：《心电与循环》2024年第4期354-357,共4页Journal of Electrocardiology and Circulation

基　　金：宁波市科技计划项目(2023Z188、2023J147)。

摘　　要：目的 观察数字减影血管造影(DSA)指导下极简式经皮植入WATCHMAN FLX左心耳封堵器的临床效果。方法2022年6月至2024年1月在宁波大学附属第一医院接受DSA指导下极简式经皮植入WATCHMAN FLX左心耳封堵器的非瓣膜性心房颤动(下称房颤)患者15例,记录手术情况和随访情况。结果 患者手术时间、X线曝光时间分别为(41.3±10.3)、(7.7±2.4)min。术中DSA检查提示左心耳口部直径最大值为(24.0±4.5)mm,左心耳深度最大值为(27.4±5.4)mm。14例患者封堵器一次性成功释放,未出现封堵器尺寸调整情况,封堵器尺寸(28.5±5.2)mm。封堵后DSA显示左心耳完全封堵,未见明显残余分流。围术期均未发生血栓栓塞事件、大出血事件、心包积液等并发症;1例(6.7%)患者出现穿刺点淤斑,1周后自行吸收。术后经食管超声心动图复查均未发现封堵器表面血栓,3例(20.0%)患者存在<3 mm残余分流。随访310(163,631)d,随访期间患者均未出现血栓栓塞事件、大出血事件。结论 非瓣膜性房颤患者DSA指导下极简式经皮植入WATCHMAN FLX左心耳封堵器是安全可行的。Objective To investigate the efficacy of minimalist percutaneous implantation of WATCHMAN FLX left atrial appendage closure(LAAC) only guided by digital subtraction angiography(DSA). Methods From June 2022 to January 2024, 15 patients with non-valvular atrial fibrillation who underwent implantation of WATCHMAN FLX guided by DSA in the First Affiliated Hospital of Ningbo University were included. The procedural and follow-up data were recorded. Results The mean operation time and fluoroscopy time were(41.3 ±10.3) min and(7.7 ±2.4) min,respectively. The maximal diameters of the orifice and maximal depth were(24.0 ±4.5) mm and(27.4 ±5.4) mm,respectively. Successful device release was achieved at the first attempt in 14 patients. Device resizing was not necessary in any patients. The size of the device was(28.5±5.2) mm. No significant peridevice leak was detected by DSA after implantation. None experienced thromboembolic events, major bleeding events or pericardial effusion periprocedurally. One(6.7%) had ecchymosis at the access site which was absorbed after one week. No device-related thrombus was detected on repeated transesophageal echocardiography post procedure. Peridevice leak <3 mm was detected in 3 patients(20.0%). After a median follow-up period of 310(163, 631) days, no thromboembolic or major bleeding events occurred. Conclusion Minimalist percutaneous implantation of WATCHMAN FLX LAAC guided by DSA in patients with non-valvular atrial fibrillation was safe and effective.

关 键 词：心房颤动 左心耳封堵术 极简式 WATCHMAN FLX封堵器 

分 类 号：R541.75[医药卫生—心血管疾病]