Division of Cardiology, San Giovanni Bosco Hospital, Turin, Italy.
Città della Scienza e della Salute, Department of Cardiology, University of Turin, Turin, Italy.
Catheter Cardiovasc Interv. 2021 Feb 15;97(3):511-515. doi: 10.1002/ccd.29161. Epub 2020 Aug 18.
Presence of thrombus in the left atrial appendage (LAA) remains a severe contraindication to the percutaneous left atrial appendage closure procedure (LAAC), due to increased embolic risk. Recently, the experience developed in cerebral protection device in transcatheter aortic valve implantation (TAVI) procedure was translated in LAAC to address this issue.
To evaluate efficacy and safety of Sentinel cerebral protection system (CPS) in supporting LAAC in real-world patient with persistent LAA thrombus.
The study retrospectively enrolled consecutive patients with non-valvular atrial fibrillation (NVAF) and thrombus in LAA who underwent LAAC supported by Sentinel CPS in seven European high-volume centres. Twenty-seven patients were included with a median age of 69.1 ± 9.7 years old, with median CHA DS -VASc and HAS-BLEED scores 3 [2-5] and 3 [2.75-4], respectively. Technical and procedural success was achieved in all patients. No periprocedural TIA, stroke, or supra-aortic trunks dissection was recorded.
In this multicenter registry, LAAC supported by Sentinel CPS in patients with LAA persistent thrombus seems to be a safe and efficacious treatment.
左心耳（LAA）内血栓的存在仍然是经皮左心耳封堵术（LAAC）的严重禁忌证，因为这会增加栓塞风险。最近，在经导管主动脉瓣植入术（TAVI）中应用的脑保护装置的经验被应用于 LAAC 来解决这个问题。
评估 Sentinel 脑保护系统（CPS）在支持持续性 LAA 血栓患者 LAAC 中的疗效和安全性。
该研究回顾性纳入了在 7 个欧洲大容量中心接受 Sentinel CPS 支持的 LAAC 的非瓣膜性心房颤动（NVAF）合并 LAA 血栓的连续患者。共纳入 27 例患者，中位年龄为 69.1±9.7 岁，CHA2DS2-VASc 和 HAS-BLEED 评分中位数分别为 3[2-5]和 3[2.75-4]。所有患者均达到技术和程序上的成功。无围手术期短暂性脑缺血发作、中风或主动脉弓分支夹层。
在这项多中心注册研究中，Sentinel CPS 支持的 LAAC 治疗持续性 LAA 血栓似乎是一种安全有效的治疗方法。
