Eng Marvin H, Wang Dee Dee
Division of Cardiology, Center for Structural Heart Disease, Henry Ford Hospital, Detroit, MI 48236, USA.
Division of Cardiology, Center for Structural Heart Disease, Henry Ford Hospital, Detroit, MI 48236, USA.
Interv Cardiol Clin. 2018 Jul;7(3):367-378. doi: 10.1016/j.iccl.2018.03.003. Epub 2018 Jun 29.
Prevention of thromboembolism in atrial fibrillation has been investigated in light of the high numbers of patients unable to be treated with effective anticoagulation. Therefore, endovascular mechanical occlusion of the left atrial appendage (LAA) has been developed as a substitute for thromboprophylaxis. Initial clinical trials demonstrated high rates of procedural complications. Using computed tomography (CT), one can ascertain accurate left atrial appendage dimensions, appendage morphology; predict radiograph gantry angles; and produce physical models for ex vivo device and catheter fitting. This is an overview of available evidence for using CT and the clinical impact of CT on endovascular LAA occlusion.
鉴于大量房颤患者无法接受有效的抗凝治疗,人们对房颤血栓栓塞的预防进行了研究。因此,已开发出左心耳(LAA)血管内机械闭塞术作为血栓预防的替代方法。初步临床试验显示手术并发症发生率很高。使用计算机断层扫描(CT),可以确定左心耳的准确尺寸、心耳形态;预测X线摄影机架角度;并制作用于体外装置和导管适配的物理模型。本文概述了使用CT的现有证据以及CT对血管内LAA闭塞术的临床影响。