Alipour Arash, Wintgens Lisette I S, Swaans Martin J, Balt Jippe C, Rensing Benno J W M, Boersma Lucas V A
Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands.
Vasc Health Risk Manag. 2017 Mar 6;13:81-90. doi: 10.2147/VHRM.S89213. eCollection 2017.
Atrial fibrillation (AF) remains an important clinical problem with severe complications such as stroke, which especially harms those with risk factors as calculated by the CHADS or CHADS-VASc. Until now, no therapy has proven 100% effective against AF. Since the left atrial appendage (LAA) is the most prominent nonvalvular AF-related thromboembolic source and (novel) oral anticoagulant [(N)OAC] carries the hazard of bleeding, LAA occlusion may be an alternative, especially in patients who are ineligible for (N)OAC therapy. In this review, we discuss several LAA occlusion techniques with a focus on the Watchman device since this device is the most thoroughly studied device of all.
心房颤动(AF)仍然是一个重要的临床问题,会引发中风等严重并发症,这对那些具有CHADS或CHADS-VASc计算出的风险因素的人危害尤其大。到目前为止,尚无治疗方法被证明对AF 100%有效。由于左心耳(LAA)是最主要的非瓣膜性AF相关血栓栓塞来源,且新型口服抗凝药(NOAC)有出血风险,LAA封堵可能是一种替代方法,特别是对于不适合NOAC治疗的患者。在本综述中,我们讨论了几种LAA封堵技术,重点是Watchman装置,因为该装置是所有装置中研究最深入的。