Cardiology Division, University Hospital of Salamanca, Salamanca, Spain.
Catheter Cardiovasc Interv. 2010 Apr 1;75(5):806-13. doi: 10.1002/ccd.22344.
It is postulated that the source of thromboembolism in 90% of patients with non-valvular atrial fibrillation (AF) arises from the left atrial appendage (LAA). Anticoagulation with warfarin is the standard medical therapy for stroke prevention in patients with AF. However, chronic warfarin therapy is contraindicated in 14 to 44% of patients with AF who are at risk for stroke. Mechanical exclusion of the LAA may prevent thrombus formation in the appendage and hence reduce the risk of stroke. Recently, several studies of percutaneous transcatheter delivery of dedicated LAA exclusion devices such as the PLAATO device, Watchman device and the Amplatzer cardiac plug, have shown encouraging results as an alternative to warfarin therapy for selected patients. This article aims to review the current evidence for LAA exclusion in patients with AF.
据推测，90%的非瓣膜性心房颤动（AF）患者的血栓栓塞源来自左心耳（LAA）。华法林抗凝是预防 AF 患者中风的标准医学治疗方法。然而，有 14%至 44%的 AF 患者存在中风风险，不适合长期使用华法林治疗。机械性排除 LAA 可能会阻止血栓在附壁上形成，从而降低中风的风险。最近，几项经皮导管输送专用 LAA 封堵装置的研究，如 PLAATO 装置、Watchman 装置和 Amplatzer 心脏塞，为选定患者提供了替代华法林治疗的令人鼓舞的结果。本文旨在回顾 AF 患者 LAA 封堵的现有证据。
