Zaidi Danish, Williams Derek, Zhao David, Upadhya Bharathi, Gilbert Olivia
Department of Internal Medicine, Yale-New Haven Hospital, New Haven, CT, United States of America.
Section of Pediatric Cardiology, Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.
Cardiovasc Revasc Med. 2022 Jul;40S:337-340. doi: 10.1016/j.carrev.2022.01.004. Epub 2022 Jan 11.
Catheter ablation for atrial fibrillation (CAAF) can result in stiff left atrial syndrome (SLAS) in up to 8% of patients. SLAS can be challenging to diagnose and difficult to distinguish from heart failure with preserved ejection fraction (HFpEF), presenting with similar signs and symptoms.
We report the first case of using an interatrial stent to maintain therapeutic benefit of atrial septostomy in a patient with symptomatic SLAS. While interatrial shunt devices have preliminarily been shown to be safe and efficacious for the treatment of HFpEF, their utilization in those with SLAS has not previously been described [1].
In patients with prior CAAF, SLAS should be considered to explain dyspnea when alternative processes have been excluded. Treatment of SLAS can be challenging with medical therapy alone, and septostomy may provide significant symptomatic benefit in these patients. Interatrial stenting can improve the patency of such interventions.
心房颤动导管消融术（CAAF）在高达8%的患者中可导致左心房僵硬综合征（SLAS）。SLAS的诊断具有挑战性，且难以与射血分数保留的心力衰竭（HFpEF）相区分，二者具有相似的体征和症状。
我们报告了首例在有症状的SLAS患者中使用房间隔支架来维持房间隔造口术治疗效果的病例。虽然房间隔分流装置已初步显示对HFpEF的治疗安全有效，但此前尚未描述其在SLAS患者中的应用[1]。
在既往接受CAAF的患者中，当排除其他病因后，应考虑SLAS来解释呼吸困难。仅用药物治疗SLAS可能具有挑战性，房间隔造口术可能为这些患者带来显著的症状改善。房间隔支架置入可提高此类干预措施的通畅性。
