Akkaya Ersan, Berkowitsch Alexander, Zaltsberg Sergej, Deubner Nikolas, Greiss Harald, Hain Andreas, Hamm Christian W, Sperzel Johannes, Neumann Thomas, Kuniss Malte
Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany.
Med. Clinic I, Justus-Liebig University, Giessen, Germany.
J Cardiovasc Electrophysiol. 2017 Sep;28(9):1048-1057. doi: 10.1111/jce.13271. Epub 2017 Aug 30.
This observational study was designed to analyze the safety and feasibility of percutaneous skin closure using a purse-string suture and compare it with the use of a compression bandage after pulmonary vein isolation.
A total of 407 patients undergoing pulmonary vein isolation (217 with radiofrequency and 190 with cryoballoon ablation) were treated with either purse-string sutures or compression bandages. The purse-string suture was applied after ablation before withdrawal of the sheaths. Patients were on bed rest for 6 hours prior to suture removal, which was accomplished 18-24 h after ablation. The compression bandage was applied after sheath withdrawal and was removed after 12 hours of bed rest. We analyzed the occurrence of any vascular or thromboembolic complication as well as hospital costs and hospital stay length after ablation. The incidence of vascular complications after compression bandage was higher than after purse-string suture in the cryoballoon and radiofrequency group (P < 0.05, respectively). The hospital costs were lower and hospital stay was shorter in both radiofrequency (4.921 ± 3.145 vs. 5.802 ± 4.006 Euro; 2.34 ± 1.32 vs. 2.98 ± 1.57 days, P < 0.05) and cryoballoon groups (4.705 ± 3.091 vs. 5.661 ± 3.563 Euro; 2.14 ± 1.37 vs. 2.61 ± 1.55 days, P < 0.05) in patients treated with a purse-string suture.
Percutaneous skin closure with a purse-string suture has the clinical impact to reduce vascular complications, hospital costs, and hospital stay length after pulmonary vein isolation.
本观察性研究旨在分析使用荷包缝合进行经皮皮肤闭合的安全性和可行性，并将其与肺静脉隔离术后使用压迫绷带的情况进行比较。
共有407例行肺静脉隔离术的患者（217例行射频消融术，190例行冷冻球囊消融术）接受了荷包缝合或压迫绷带治疗。荷包缝合在消融后、鞘管撤出前应用。患者在缝合拆除前卧床休息6小时，缝合拆除在消融后18 - 24小时进行。压迫绷带在鞘管撤出后应用，卧床休息12小时后拆除。我们分析了消融后任何血管或血栓栓塞并发症的发生情况以及住院费用和住院时间。冷冻球囊组和射频组中，使用压迫绷带后的血管并发症发生率高于使用荷包缝合后（分别为P < 0.05）。在射频组（4.921 ± 3.145欧元对5.802 ± 4.006欧元；2.34 ± 1.32天对2.98 ± 1.57天，P < 0.05）和冷冻球囊组（4.705 ± 3.091欧元对5.661 ± 3.563欧元；2.14 ± 1.37天对2.61 ± 1.55天，P < 0.05）中，接受荷包缝合治疗的患者住院费用更低且住院时间更短。
使用荷包缝合进行经皮皮肤闭合对减少肺静脉隔离术后的血管并发症、住院费用和住院时间具有临床意义。
