Department of Cardiology, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain.
EuroIntervention. 2021 Feb 5;16(15):e1288-e1294. doi: 10.4244/EIJ-D-20-00886.
The aim of this study was to evaluate the impact of pulmonary ridge (PR) coverage on both clinical and imaging follow-up outcomes in patients undergoing left atrial appendage occlusion (LAAO).
The study included consecutive patients with non-valvular atrial fibrillation who underwent LAAO with disc and lobe devices. Patients were classified into two groups according to the PR coverage. A total of 147 patients were included. Among these, the PR was covered in 109 (74%) and uncovered in 38 (26%). Successful implantation was achieved in 98.6%. No differences in procedural outcomes were observed between the groups. The rate of procedural major adverse events was 3% (only major bleedings and/or vascular access complications). No device embolisation, cardiac tamponade or in-hospital mortality was observed. After a mean follow-up of 1.77±2.2 years, the annualised ischaemic stroke and major bleeding rate was 1.3%/year and 6.5%/year, respectively, without differences between groups. At follow-up, patients with a covered PR presented a lower incidence of device-related thrombosis (DRT) (1%) than those with an uncovered PR (27%); p<0.001. In multivariable analysis, the presence of PR coverage emerged as an independent predictor of DRT.
Pulmonary ridge coverage was associated with a lower incidence of DRT after LAAO. Procedural and follow-up clinical outcomes did not differ between covered PR and uncovered PR patients.
本研究旨在评估肺嵴（PR）覆盖对接受左心耳封堵（LAAO）治疗的患者的临床和影像学随访结果的影响。
该研究纳入了连续接受盘状和叶状装置行 LAAO 的非瓣膜性心房颤动患者。根据 PR 覆盖情况将患者分为两组。共纳入 147 例患者，其中 109 例（74%）PR 覆盖，38 例（26%）PR 未覆盖。手术成功率为 98.6%。两组间手术结果无差异。主要不良事件发生率为 3%（仅为大出血和/或血管通路并发症）。未观察到器械栓塞、心脏压塞或院内死亡。平均随访 1.77±2.2 年后，缺血性卒中和大出血的年发生率分别为 1.3%/年和 6.5%/年，两组间无差异。随访时，PR 覆盖患者的器械相关血栓形成（DRT）发生率（1%）低于 PR 未覆盖患者（27%）；p<0.001。多变量分析显示，PR 覆盖的存在是 DRT 的独立预测因素。
LAAO 后 PR 覆盖与 DRT 发生率降低相关。覆盖 PR 和未覆盖 PR 患者的手术和随访临床结果无差异。
