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新型封堵器行左心耳封堵术:疗效、安全性及中期性能

Left Atrial Appendage Closure with a New Occluder Device: Efficacy, Safety and Mid-Term Performance.

作者信息

Llagostera-Martín Marc, Cubero-Gallego Hector, Mas-Stachurska Aleksandra, Salvatella Neus, Sánchez-Carpintero Andrea, Tizon-Marcos Helena, Garcia-Guimaraes Marcos, Calvo-Fernandez Alicia, Molina Luis, Vaquerizo Beatriz

机构信息

Interventional Cardiology Unit, Cardiology Department, Hospital del Mar, 08003 Barcelona, Spain.

Heart Diseases Biomedical Research Group (GREC), Hospital del Mar Medical Investigation Institute-IMIM, 08003 Barcelona, Spain.

出版信息

J Clin Med. 2021 Apr 1;10(7):1421. doi: 10.3390/jcm10071421.

Abstract

The LAmbre device is a novel system designed for left atrial appendage closure (LAAC). First registries showed a high rate of device implantation success. However, few mid-term results are available. We present our 1- and 12-month follow-up results for this device. This prospective, single-center registry included consecutive patients with nonvalvular atrial fibrillation who underwent LAAC with the LAmbre device. Transesophageal echocardiography (TEE) was performed at 1-month follow-up. In total, 55 patients were included. The population was elderly (75 ± 9.4 years), with a high proportion of comorbidities. The mean CHADS-VASc and HAS-BLED scores were 4.6 ± 1.6 and 3.9 ± 1.0, respectively. Previous history of a major bleeding event was present in 37 patients (67.3%). Procedural success was achieved in 54 patients (98.2%). Device success was achieved in 100% of patients in whom device implantation was attempted (54 patients). Major in-hospital device-related complications included mortality of one patient (1.8%) and pericardial tamponade in two patients (3.6%); the incidence of stroke was 0%. No thrombus or significant leaks (≥5 mm) were observed on 1-month TEE. At 12 months, adverse events were overall death (1.8%), transient ischemic attack/ischemic stroke (1.8%), and major bleeding events (Bleeding Academic Research Consortium (BARC) 3a and 3c; 11%). In this high-risk population, the LAmbre device seems to be a safe and effective option for LAAC with a remarkable mid-term performance.

摘要

LAmbre装置是一种专为左心耳封堵(LAAC)设计的新型系统。首批注册研究显示该装置植入成功率很高。然而,中期结果较少。我们展示了该装置1个月和12个月的随访结果。这项前瞻性单中心注册研究纳入了连续接受LAmbre装置LAAC治疗的非瓣膜性房颤患者。在1个月随访时进行经食管超声心动图(TEE)检查。总共纳入了55例患者。患者群体年龄较大(75±9.4岁),合并症比例较高。CHADS-VASc和HAS-BLED评分的平均值分别为4.6±1.6和3.9±1.0。37例患者(67.3%)有重大出血事件既往史。54例患者(98.2%)手术成功。在尝试植入装置的患者(54例)中,装置成功率达到100%。主要的院内装置相关并发症包括1例患者死亡(1.8%)和2例患者发生心包填塞(3.6%);卒中发生率为0%。1个月TEE检查未观察到血栓或显著渗漏(≥5mm)。在12个月时,不良事件包括全因死亡(1.8%)、短暂性脑缺血发作/缺血性卒中(1.8%)和重大出血事件(出血学术研究联盟(BARC)3a和3c级;11%)。在这个高危人群中,LAmbre装置似乎是LAAC的一种安全有效的选择,中期表现出色。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71a6/8036586/818283ddc2ff/jcm-10-01421-g001.jpg

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