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应对左心耳以预防中风:器械与决策制定

Dealing With the Left Atrial Appendage for Stroke Prevention: Devices and Decision-Making.

作者信息

Phillips Karen P, Paul Vince

机构信息

HeartCare Partners, GenesisCare, Greenslopes Private Hospital, Greenslopes, Brisbane, Qld, Australia.

Fiona Stanley Hospital, Perth, WA, Australia.

出版信息

Heart Lung Circ. 2017 Sep;26(9):918-925. doi: 10.1016/j.hlc.2017.05.113. Epub 2017 May 17.

Abstract

Left atrial appendage (LAA) device occlusion represents a major evolution in stroke prevention for atrial fibrillation (AF). Left atrial appendage device occlusion is now a proven strategy which provides long-term thromboembolic stroke prevention for patients with non-rheumatic AF. Evidence supports its benefit as an alternative to long-term anticoagulation while mitigating long-term bleeding risks and improving cardiovascular mortality. The therapy offers expanded options to physicians and patients negotiating stroke prevention (both primary and secondary prevention), but a good understanding of the risks and benefits is required for decision-making. This review aims to summarise the evolution of LAA device occlusion therapy, current knowledge in the field and a snapshot of current status of the therapy in clinical practice in Australia and around the world.

摘要

左心耳(LAA)封堵术是心房颤动(AF)卒中预防领域的一项重大进展。左心耳封堵术现已成为一种经证实的策略,可为非风湿性AF患者提供长期的血栓栓塞性卒中预防。有证据支持其作为长期抗凝治疗的替代方案的益处,同时可降低长期出血风险并改善心血管死亡率。该疗法为医生和患者在卒中预防(包括一级预防和二级预防)方面提供了更多选择,但在决策时需要充分了解其风险和益处。本综述旨在总结LAA封堵术治疗的发展历程、该领域的当前知识以及澳大利亚和全球临床实践中该疗法的现状概况。

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