Division of Cardiology, Department of Medicine III, University Hospital Frankfurt, Goethe University Frankfurt Am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Center of Cardiology, Cardiology 1, University Medical Center Mainz, Mainz, Germany.
BMC Cardiovasc Disord. 2022 Aug 2;22(1):349. doi: 10.1186/s12872-022-02786-4.
Percutaneous left atrial appendage occlusion (LAAO) represents an alternative stroke prevention method in patients with atrial fibrillation and an increased bleeding risk, chronic kidney disease or contraindications to oral anticoagulants. Aim of our study was to evaluate the feasibility and safety of percutaneous LAAO in high-risk, frail patients having undergone transcatheter aortic valve implantation (TAVI).
Thirty-one patients having undergone TAVI and scheduled for LAAO were prospectively included in our study.
Implantation was successful in 29 of 31 cases (93.5%).There were no patients that developed a major acute cardiovascular event, stroke, or device dislocation/embolization. There was a single case of major bleeding (3.2%) and 3 cases of acute kidney injury (9.7%). At 3 months, no patients experienced a stroke, one patient had a device-related thrombus (3.4%), one patient showed a significant peri-device leak, and one patient had a persistent iatrogenic atrial septal defect.
Our study shows that percutaneous LAAO may represent a feasible alternative strategy for stroke prevention, that can be safely performed in high-risk, multimorbid patients with high bleeding risk or contraindications to oral anticoagulation.
经皮左心耳封堵术（LAAO）代表了一种替代的预防房颤患者中风的方法，这些患者具有出血风险增加、慢性肾脏病或口服抗凝剂禁忌等情况。我们的研究目的是评估在经导管主动脉瓣置换术（TAVI）后高风险、虚弱的患者中进行经皮 LAAO 的可行性和安全性。
31 例接受 TAVI 并计划进行 LAAO 的患者前瞻性纳入本研究。
29 例（93.5%）患者的植入术获得成功。无患者发生重大急性心血管事件、中风或器械脱位/栓塞。有 1 例（3.2%）严重出血和 3 例（9.7%）急性肾损伤。3 个月时，无患者发生中风，1 例患者出现器械相关血栓形成（3.4%），1 例患者出现明显的器械周围漏，1 例患者存在持续性医源性房间隔缺损。
我们的研究表明，经皮 LAAO 可能是一种预防中风的可行替代策略，可以安全地应用于具有高出血风险或口服抗凝剂禁忌的高风险、多病共存的患者。
