Di Muro Francesca Maria, Stolcova Miroslava, Di Mario Carlo, Meucci Francesco
Structural Interventional Cardiology, Department of Clinical and Experimental Medicine, Careggi University Hospital, Clinica Medica, Room 124, Largo Brambilla 3, 50134 Florence, Italy.
Eur Heart J Case Rep. 2022 Apr 26;6(5):ytac176. doi: 10.1093/ehjcr/ytac176. eCollection 2022 May.
Percutaneous left atrial appendage closure (LAAC) is an emerging alternative to oral anticoagulation for stroke prevention in atrial fibrillation (AF) in patients with AF, elevated stroke risk and contraindications to long-term anticoagulation treatment. Optimal pre-procedural planning is essential to ensure optimal procedural results.
We report the case of a 62-year-old man with a history of right cerebellar haematoma referred for LAA closure. We describe the first use of FEops HEARTguide patient-specific computational simulation in the planning of LAAC with the Watchman Flex device (Boston Scientific, Marlborough, MA, USA) in an unusual 'whale tail'-like LAA anatomy.
Percutaneous left atrial appendage (LAA) closure is feasible in the majority of patients. However, certain LAA anatomies may pose substantial technical challenges. This case shows the crucial role of a pre-procedural assessment based on patient-specific computational simulations for LAA closure in difficult scenarios resulting in a more efficient procedure with the optimal result and good clinical outcomes.
经皮左心耳封堵术（LAAC）是房颤（AF）患者中预防卒中的一种新兴替代口服抗凝治疗的方法，这些患者具有房颤、卒中风险升高以及长期抗凝治疗禁忌证。最佳的术前规划对于确保最佳手术效果至关重要。
我们报告了一名62岁男性患者的病例，该患者有右小脑血肿病史，前来接受左心耳封堵术。我们描述了在使用Watchman Flex装置（美国马萨诸塞州马尔伯勒市波士顿科学公司）对一名具有不寻常“鲸尾”样左心耳解剖结构的患者进行LAAC手术规划时首次使用FEops HEARTguide患者特异性计算模拟的情况。
经皮左心耳（LAA）封堵术在大多数患者中是可行的。然而，某些左心耳解剖结构可能带来重大技术挑战。本病例显示了基于患者特异性计算模拟的术前评估在困难情况下进行LAA封堵术中的关键作用，从而实现更高效的手术，获得最佳结果和良好的临床结局。
