Department of Cardiology, Heart Center, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen 2100, Denmark.
Department of Cardiology, Heart Center, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen 2100, Denmark.
Card Electrophysiol Clin. 2020 Mar;12(1):67-75. doi: 10.1016/j.ccep.2019.10.003. Epub 2019 Dec 25.
Left atrial appendage closure (LAAC) is noninferior to oral vitamin K antagonist therapy for the reduction of nonvalvular atrial fibrillation-related stroke risk. Currently, the procedure is most widely accepted in patients who cannot tolerate oral anticoagulants. This patient population is generally comorbid, making any reduction in procedural complications paramount. LAAC has important complications described in the periprocedural and postprocedural periods. The prevention and management of complications regarding vascular access, transseptal puncture, pericardial effusion, device embolization, stroke, air embolusperidevice leak, device-related thrombus and device erosion/ late pericardial effusion are discussed.
左心耳封堵术(LAAC)在降低非瓣膜性房颤相关卒中风险方面不劣于口服维生素 K 拮抗剂治疗。目前,该手术在不能耐受口服抗凝剂的患者中应用最广泛。该患者人群通常合并多种疾病,因此任何手术并发症的减少都至关重要。LAAC 在围手术期和术后均有重要并发症。本文讨论了血管入路、房间隔穿刺、心包积液、器械栓塞、卒中等并发症的预防和处理,以及器械相关血栓形成和器械侵蚀/迟发性心包积液。