Department of Cardiology, Sussex Cardiac Centre, Brighton and Sussex University Hospitals, United Kingdom.
Catheter Cardiovasc Interv. 2018 Dec 1;92(7):1439-1443. doi: 10.1002/ccd.27791. Epub 2018 Sep 23.
We evaluated the safety and efficacy of percutaneous left atrial appendage (LAA) occlusion performed as a day case procedure.
LAA occlusion has been shown to be safe and effective for stroke prevention in patients with atrial fibrillation. It has not been shown if the procedure can safely be performed on a day-case basis.
Retrospective analysis was made of 117 LAA occlusion procedures in a single large teaching hospital in the UK. Procedural success, procedural complications, length of stay, and readmission data were examined.
Successful deployment of a device was possible in all but one patient (whose appendage was too large). Major in-hospital complications occurred in 1.7% of patients (both femoral vascular). Same-day discharge was made in 66% of patients overall. Since January 2016, only 3 of 59 patients (5%) have remained in hospital overnight following LAAO. Echocardiography 2-4 hr postprocedure was undertaken prior to discharge. One patient was readmitted within 7 days but this readmission would not have been prevented by overnight stay.
LAA occlusion can be safely performed as a day case procedure with acceptable complication rates and no increment of complications related to the lack of routine overnight stay.
我们评估了经皮左心耳（LAA）封堵术作为日间手术的安全性和有效性。
LAA 封堵术已被证明可安全有效地预防房颤患者的中风。目前尚不清楚该手术是否可以安全地作为日间手术进行。
对英国一家大型教学医院的 117 例 LAA 封堵术进行回顾性分析。检查了手术成功率、手术并发症、住院时间和再入院数据。
除了一名患者（其心耳过大）外，所有患者均成功植入了设备。主要院内并发症发生率为 1.7%（均为股血管）。总体而言，66%的患者可当天出院。自 2016 年 1 月以来，在 LAAO 后仅 59 例患者中的 3 例（5%）需要过夜住院。在出院前，术后 2-4 小时进行了超声心动图检查。一名患者在 7 天内再次入院，但这种再入院不会因夜间住院而得到预防。
LAA 封堵术可以作为日间手术安全进行，并发症发生率可接受，且与缺乏常规夜间住院无关的并发症无增加。
