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左心房内有直升机的飞行员:一例封堵器栓塞病例报告

A pilot with a helicopter in the left atrium: a case report of an embolized Watchman device.

作者信息

Halim Jonathan, Tavernier Rene, Missault Luc, Debonnaire Philippe

机构信息

Department of Cardiology, Sint-Jan Hospital Bruges, Ruddershove 10, 8000 Bruges, Belgium.

出版信息

Eur Heart J Case Rep. 2020 Jul 9;4(4):1-4. doi: 10.1093/ehjcr/ytaa161. eCollection 2020 Aug.

Abstract

BACKGROUND

Embolization of a Watchman device in patients undergoing percutaneous left atrial appendage (LAA) closure is a rare complication. Retrieval of the device can be achieved percutaneously with a snaring technique or a bioptome.

CASE SUMMARY

We present an illustrative case of Watchman closure device embolization during an LAA closure attempt in a 77-year-old man. The complication was caused by anatomical restraints of the LAA, in particular limited depth resulting in poor stability of the closure device after implantation. By the use of a double snaring technique, however, we managed to retrieve the device percutaneously. By applying such strategy, a more invasive surgical approach can be prevented.

DISCUSSION

Prompt response is needed when embolization of a Watchman device occurs. A snaring technique can be used in most cases to attempt device retrieval. A double snaring technique is in this case associated with higher retrieval success than a single snaring technique.

摘要

背景

在接受经皮左心耳(LAA)封堵术的患者中,Watchman装置栓塞是一种罕见的并发症。可通过圈套技术或活检钳经皮取出该装置。

病例摘要

我们展示了一名77岁男性在LAA封堵尝试过程中Watchman封堵装置栓塞的典型病例。该并发症是由LAA的解剖限制引起的,特别是深度有限,导致植入后封堵装置稳定性差。然而,通过使用双重圈套技术,我们成功地经皮取出了该装置。通过应用这种策略,可以避免采用更具侵入性的手术方法。

讨论

Watchman装置发生栓塞时需要迅速做出反应。在大多数情况下,可以使用圈套技术尝试取出装置。在这种情况下,双重圈套技术比单一圈套技术的取出成功率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1bb/7780468/f7b22378022f/ytaa161f1.jpg

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