University Heart Center, Zurich, Switzerland; 2. HerzZentrum Hirslanden, Zurich, Switzerland.
EuroIntervention. 2017 Mar 20;12(16):1940-1945. doi: 10.4244/EIJ-D-16-00784.
The aim of our study is to report our single-centre experience with concomitant MitraClip (MC) and left atrial appendage occlusion (LAAO) and further to assess the feasibility, safety and short-term outcome of such an approach.
Twenty-five consecutive patients underwent MC with concomitant LAAO at our hospital (combined group). As a control group, 25 consecutive patients with atrial fibrillation (AF) undergoing standalone MC were selected. Baseline parameters were equal between the two groups. Patients in the combined group had longer procedural time (90.0 min vs. 66.0 min, p=0.02) and radiation time (32.0 min vs. 18.0 min, p=0.01). There were no procedural deaths. At 30 days, one patient died due to cerebral haemorrhage (combined vs.
4% vs. 0%, p=0.32) and two had acute kidney injury (combined vs.
4% vs. 4%, p=1.00). In multivariate analysis, the association of LAAO with device or procedural success was not significant.
LAAO along with MC in a single stage procedure is feasible. These preliminary results have to be validated in a large randomised study, in order to assess the efficacy of combined LAAO that can be expected to become evident only after longer follow-up.
本研究旨在报告我们单中心同期使用 MitraClip（MC）和左心耳封堵（LAAO）的经验，并进一步评估这种方法的可行性、安全性和短期结果。
在我院，25 例连续患者接受了同期 MC 和 LAAO（联合组）。作为对照组，选择了 25 例连续接受单纯 MC 的房颤（AF）患者。两组的基线参数相等。联合组的手术时间（90.0 分钟 vs. 66.0 分钟，p=0.02）和放射时间（32.0 分钟 vs. 18.0 分钟，p=0.01）更长。无手术死亡病例。在 30 天时，1 例患者因脑出血死亡（联合组 vs. 对照组：4% vs. 0%，p=0.32），2 例患者发生急性肾损伤（联合组 vs. 对照组：4% vs. 4%，p=1.00）。多变量分析显示，LAAO 与器械或手术成功的相关性不显著。
在单阶段手术中同时进行 LAAO 和 MC 是可行的。这些初步结果需要在大规模随机研究中得到验证，以评估联合 LAAO 的疗效，这种疗效可能只有在更长的随访后才能显现出来。
