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仅经食管超声心动图引导下的左心耳封堵术。

Left Atrial Appendage Occlusion Guided Only by Transesophageal Echocardiography.

作者信息

Zhao Jinlong, Li Feng, Zhang Yueli, Zhuang Zhongyun, Wang Man, Fu Liang, Ni Yinkai, Lu Zhexin, Chen Zonghui, Zhang Cheng

机构信息

Department of Cardiovascular Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

Department of Ultrasound Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

出版信息

Cardiol Res Pract. 2019 Jan 2;2019:1376515. doi: 10.1155/2019/1376515. eCollection 2019.

DOI:10.1155/2019/1376515
PMID:30719340
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6334355/
Abstract

AIMS

To investigate a new method of left atrial appendage occlusion without fluoroscopy.

METHODS AND RESULTS

We performed left atrial appendage occlusion for 14 patients with atrial fibrillation in our hospital. All of the surgeries were completed in a general surgery setting, avoiding fluoroscopy, and in each case, the entire procedure was guided by transesophageal echocardiography (TEE). All of the surgeries were performed through the femoral vein pathway. All operations went smoothly with no serious complications. Postoperative TEE indicated that each device was in a good position, and there was no residual shunt around any of the devices.

CONCLUSIONS

TEE-guided left atrial appendage occlusion is safe and reliable, simplifies the procedure, protects doctors and patients from radiation, and is gradually becoming the mainstream operation for left atrial appendage occlusion. This trial is registered with ChiCTR1800018387.

摘要

目的

研究一种无需荧光透视的左心耳封堵新方法。

方法与结果

我们在我院对14例房颤患者进行了左心耳封堵。所有手术均在普通外科环境下完成,避免了荧光透视,且每例手术全程均由经食管超声心动图(TEE)引导。所有手术均通过股静脉途径进行。所有手术均顺利完成,无严重并发症。术后TEE显示每个装置位置良好,且装置周围无残余分流。

结论

TEE引导下的左心耳封堵安全可靠,简化了手术过程,保护医生和患者免受辐射,正逐渐成为左心耳封堵的主流术式。本试验已在中国临床试验注册中心注册,注册号为ChiCTR1800018387。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8086/6334355/9df973a9f0ac/CRP2019-1376515.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8086/6334355/9df973a9f0ac/CRP2019-1376515.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8086/6334355/9df973a9f0ac/CRP2019-1376515.001.jpg

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Ann Card Anaesth. 2016 Oct-Dec;19(4):589-593. doi: 10.4103/0971-9784.191548.
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Rotational method simplifies 3-dimensional measurement of left atrial appendage dimensions during transesophageal echocardiography.旋转法简化了经食管超声心动图检查时左心耳尺寸的三维测量。
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Percutaneous left atrial appendage occlusion: the Munich consensus document on definitions, endpoints, and data collection requirements for clinical studies.
经皮左心耳封堵术:关于临床研究定义、终点和数据收集要求的慕尼黑共识文件
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Eur Heart J. 2016 Dec 7;37(46):3470-3482. doi: 10.1093/eurheartj/ehw048. Epub 2016 Mar 1.
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Association between incomplete surgical ligation of left atrial appendage and stroke and systemic embolization.左心耳未完全结扎与卒中和全身性栓塞的关系。
Heart Rhythm. 2015 Jul;12(7):1431-7. doi: 10.1016/j.hrthm.2015.03.028. Epub 2015 May 18.
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Europace. 2015 Apr;17(4):642-6. doi: 10.1093/europace/euv069.
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Periprocedural intracardiac echocardiography for left atrial appendage closure: a dual-center experience.经皮左心耳封堵术中心内超声检查:一项双中心经验。
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