Asami Masahiko
Division of Cardiology, Mitsui Memorial Hospital, Kanda-Izumicho 1, Chiyoda-ku, Tokyo, 101-8643, Japan.
Cardiovasc Interv Ther. 2022 Jul;37(3):440-449. doi: 10.1007/s12928-022-00852-4. Epub 2022 Mar 20.
Percutaneous left atrial appendage closure (LAAC) has been reported many therapeutic effects with regard to its safety and efficacy, and the number of patients with non-valvular atrial fibrillation undergoing LAAC is increasing worldwide. Although it is a highly safe procedure, further improvements are expected and preoperative planning is extremely important. For this purpose, transesophageal echocardiography has been mainly performed so far, however, nowadays, it is recommended to determine a more optimal treatment strategy combined with computed tomography. Preoperative CT predicts not only the risk of the intervention based on anatomical features of the left atrial appendage (LAA) but also the device type and size, sheath type, optimal location for septal puncture and pre-procedurally clarifies the left atrium and LAA dimensions. Furthermore, postoperative CT can evaluate device-related thrombus and peri-device leak, making it possible to observe the postoperative course using less invasive methods. This study reviews the practical utility of CT in pre- and post-LAAC.
经皮左心耳封堵术（LAAC）在安全性和有效性方面已展现出诸多治疗效果，全球范围内接受LAAC的非瓣膜性心房颤动患者数量正在增加。尽管这是一种高度安全的手术，但仍期望进一步改进，术前规划极为重要。迄今为止，主要通过经食管超声心动图进行此项检查，然而如今建议结合计算机断层扫描来确定更优化的治疗策略。术前CT不仅能根据左心耳（LAA）的解剖特征预测干预风险，还能预测器械类型和尺寸、鞘管类型、房间隔穿刺的最佳位置，并在术前明确左心房和LAA的尺寸。此外，术后CT可评估与器械相关的血栓和器械周围渗漏情况，从而能够使用侵入性较小的方法观察术后病程。本研究回顾了CT在LAAC术前和术后的实际应用价值。
