Lerakis Stamatios, Synetos Andreas
Emory University School of Medicine, Division of Cardiology, 1365A Clifton Road, NE, Suite AT-503, Atlanta, GA 30322, USA.
Future Cardiol. 2007 Sep;3(5):507-9. doi: 10.2217/14796678.3.5.507.
Sick PB, Schuler G, Hauptmann KE et al.: Initial worldwide experience with the WATCHMAN left atrial appendage system for stroke prevention in atrial fibrillation. J. Am. Coll. Cardiol. 49(13), 1490-1495 (2007). Left atrium appendage (LAA) occlusion is a potential alternative to warfarin in patients with atrial fibrillation who have contraindications to anticoagulation. Currently, there are two devices specifically designed for LAA occlusion: the percutaneous LAA transcatheter occlusion (PLAATO System, ev3 Inc., MN, USA) and the WATCHMAN LAA system (Atritech Inc., MN, USA). Initial results from a study with the WATCHMAN device suggest that the LAA occlusion may reduce the long-term risk for stroke. Available data are still very limited and although occluding the LAA appears to be technically feasible, its long-term safety and ability to reduce stroke incidence remains to be proven. Only prospective randomized studies will be able to tell us if the LAA occlusion devices can be used as an alternative treatment strategy to the standard long-term anticoagulation.
西克·PB、舒勒·G、豪普特曼·KE等人:全球首次使用WATCHMAN左心耳封堵系统预防房颤患者中风的经验。《美国心脏病学会杂志》49(13),1490 - 1495(2007年)。对于有抗凝治疗禁忌证的房颤患者,左心耳封堵术是华法林的一种潜在替代方法。目前,有两种专门设计用于左心耳封堵的装置:经皮左心耳导管封堵术(PLAATO系统,美国明尼苏达州ev3公司)和WATCHMAN左心耳系统(美国明尼苏达州Atritech公司)。一项关于WATCHMAN装置的研究初步结果表明,左心耳封堵术可能降低中风的长期风险。现有数据仍然非常有限,虽然封堵左心耳在技术上似乎可行,但其长期安全性和降低中风发生率的能力仍有待证实。只有前瞻性随机研究才能告诉我们左心耳封堵装置是否可以作为标准长期抗凝治疗的替代治疗策略。