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一种使用自制圈套经皮取出胸主动脉内 Watchman 左心耳封堵装置的简单技术。

A Simple Percutaneous Retrieval Technique for an Embolized Watchman Left Atrial Appendage Closure Device in the Thoracic Aorta Using a Homemade Snare.

机构信息

Binawaluya Cardiac Center.

Faculty of Medicine, Universitas Sumatera Utara.

出版信息

Int Heart J. 2021 Sep 30;62(5):1153-1155. doi: 10.1536/ihj.20-790. Epub 2021 Sep 17.

Abstract

A 60-year old male with paroxysmal atrial fibrillation underwent a combined procedure of left atrial appendage occlusion and pulmonary vein isolation. However, an acute intraprocedural 24-mm Watchman device dislodgement occurred, and thus a decision for urgent surgery was made. However, it was noted during the surgery that the device had migrated further to the descending aorta, just distal to the left subclavian artery. Since a right sternotomy access for retrieval was not feasible, a percutaneous approach was justified. A homemade snare was created using a combination of a long sheath, J-wire, and a regular snare, and the device was successfully retrieved without significant difficulty.

摘要

一位 60 岁男性患有阵发性心房颤动,接受了左心耳封堵术和肺静脉隔离术的联合治疗。然而,在手术过程中发生了急性 24 毫米 Watchman 装置移位,因此决定紧急进行手术。然而,术中发现装置进一步迁移到降主动脉,就在左锁骨下动脉的远端。由于经右胸骨切开术进行取出不可行,因此采用了经皮方法。使用长鞘、J 型导丝和普通圈套器组合制作了一个自制圈套器,并成功地取出了装置,没有出现明显的困难。

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