Watchman FLX^(TM)新型左心耳封堵器联合手术的临床观察  

Clinical observation of combined procedures during percutaneous left atrial appendage closure using Watchman FLX^(TM)

作　　者：薛建颖 谢航 杜亚娟[2] 何璐[2] 谢学刚 王海燕[2] 张玉顺[2] XUE Jian-ying;XIE Hang;DU Ya-juan;HE Lu;XIE Xue-gang;WANG Hai-yan;ZHANG Yu-shun(Department of Cardiology,Shaanxi Provincial People’s Hospital,Xi’an 710068,Shaanxi,China;Department of Structural Heart Disease,First Affiliated Hospital,Xi’an Jiaotong University,Xi’an 710061,Shaanxi,China)

机构地区：[1]陕西省人民医院心内科,陕西西安710068 [2]西安交通大学第一附属医院结构性心脏病科,陕西西安710061

出　　处：《心脏杂志》2025年第2期172-177,共6页Chinese Heart Journal

摘　　要：目的观察WatchmanFLX^(TM)新型左心耳封堵器在房颤患者联合手术中的疗效。方法回顾性分析西安交通大学第一附属医院自2022年6月~2023年3月应用Watchman FLX^(TM)新型左心耳封堵器进行介入手术或Watchman FLX^(TM)新型左心耳封堵器联合其它心脏介入手术的患者94例。回顾患者基线特征、临床特征、手术及随访数据,观察Watchman FLX^(TM)新型左心耳封堵器在房颤患者联合手术中的疗效。结果与单纯LAAO组比较,联合手术组心力衰竭比例升高(P<0.01),动脉血管疾病比例升高(P<0.05),两组患者年龄、性别、体质量指数、高血压比例、糖尿病比例、射血分数、肌酐值、CKD分期、透析比例、出血病史比例、CHA2DS2-VASc评分、HASBLED评分及LAAO适应证等指标两组间无显著统计学差异。联合手术组术中选择局部麻醉及使用ICE的比例更高,手术时间和透视时间更长。封堵器尺寸与压缩比两组间无明显统计学差异。所有封堵器都成功植入,且无更换封堵器的病例。两组患者均无围术期并发症及术后器械相关不良事件的发生。此外,随访期间两组均无大出血事件、缺血性卒中、心包积液、心外科手术、死亡等临床不良事件发生。结论使用Watchman FLX^(TM)新型左心耳封堵器进行联合手术短期观察显示其具有良好的手术成功率及较低的不良事件发生率。AIM To describe our observation on combined left atrial appendage closure(LAAC)procedures using Watchman FLX^(TM) devices.METHODS Ninety-four patients underwent LAAC procedures using Watchman FLX^(TM) devices in the First Affiliated Hospital of Xi’an Jiaotong University from June 2022 to March 2023 were included for this study.The characteristics of demographics,perioperative and periprocedural complications,adverse events and clinical outcome were described.RESULTS Compared with the simple LAAO group,the proportion of heart failure in the combined operation group increased(P<0.01),and the proportion of arterial vascular disease increased(P<0.05).There was no significant statistical difference between the two groups in terms of age,gender,body mass index,proportion of hypertension,proportion of diabetes,ejection fraction,creatinine value,CKD stage,dialysis proportion,proportion of hemorrhagic disease history,CHA2DS2-VASc score,HAS-BLED score,LAAO indications and other indicators.The proportion of choosing local anesthesia and using ICE during surgery was higher,and the surgery time and fluoroscopy time were longer in the combined operation group.There was no significant statistical difference in the size and compression ratio of the occluder between the two groups.All occluders were successfully implanted,and there was no cases of occluder replacement.Both groups of patients had no perioperative complications or postoperative instrument related adverse events.In addition,during the follow-up period,there were no clinical adverse events such as major bleeding,ischemic stroke,pericardial effusion,cardiac surgery,or death in both groups.CONCLUSION Short-term observation of combined procedures using Watchman FLX^(TM) left atrial appendage occluder shows a good success rate and a low incidence of adverse events.

关 键 词：左心耳封堵术 联合手术 心房颤动 卒中 

分 类 号：R541.75[医药卫生—心血管疾病]