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LAmbre 装置行左心耳封堵术后发生器械相关渗漏的发生率、风险因素及临床影响:一项前瞻性多中心临床研究的数据。

Incidence, risk factors, and clinical impact of peridevice leak following left atrial appendage closure with the LAmbre device-Data from a prospective multicenter clinical study.

机构信息

Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.

Department of Cardiology, Cardiovascular Research Institute of Wuhan University, Wuhan, Hubei, China.

出版信息

J Cardiovasc Electrophysiol. 2021 Feb;32(2):354-359. doi: 10.1111/jce.14824. Epub 2020 Dec 7.

Abstract

BACKGROUND

In the present study, we sought to explore the incidence, risk factors, and clinical impact of peridevice leaks (PDLs), following LAmbre-assisted left atrial appendage closure (LAAC).

METHODS

We performed transesophageal echocardiography (TEE) on patients participating in the LAmbre multicenter study, at Day 1 postimplantation, then at 3 and 12 months to assess PDL, device-related thrombus, left atrial appendage (LAA) thrombus, and left atrial thrombus. Clinical events were recorded during follow-up.

RESULT

A total of 152 patients with atrial fibrillation successfully completed LAAC. At 3 months follow-up, 123 patients underwent TEE, with 21 (17%) of them presenting PDL. Among the 121 patients who underwent TEE at 12 months follow-up, 19 (15.7%) presented PDL. Patients with PDL exhibited larger LAA orifice diameters and larger device sizes compared to those in the no leak group. In addition, we found no significant differences in thromboembolic events between patients in the PDL and no leak groups.

CONCLUSION

LAmbre-assisted LAA closure resulted in a relatively low PDL occurrence, and its rate decreased over time. In addition, PDL was more prominent in patients with larger LAA orifice diameter and larger device size. However, the condition was not associated with an increased risk for thromboembolic events.

摘要

背景

在本研究中,我们旨在探讨 LAmbre 辅助左心耳封堵(LAAC)术后设备相关渗漏(PDL)的发生率、风险因素和临床影响。

方法

我们对参与 LAmbre 多中心研究的患者在植入后第 1 天、第 3 个月和第 12 个月进行经食管超声心动图(TEE)检查,以评估 PDL、设备相关血栓、左心耳(LAA)血栓和左心房血栓。在随访期间记录临床事件。

结果

共有 152 例心房颤动患者成功完成 LAAC。在 3 个月随访时,有 123 例患者进行了 TEE,其中 21 例(17%)出现 PDL。在 12 个月随访时进行 TEE 的 121 例患者中,有 19 例(15.7%)出现 PDL。与无渗漏组相比,PDL 患者的 LAA 开口直径和设备尺寸更大。此外,我们发现 PDL 组和无渗漏组之间血栓栓塞事件无显著差异。

结论

LAmbre 辅助 LAAC 术后 PDL 发生率相对较低,且随着时间的推移发生率降低。此外,PDL 在 LAA 开口直径和设备尺寸较大的患者中更为明显。然而,这种情况与血栓栓塞事件的风险增加无关。

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