Chang Sheng-Nan, Chiu Fu-Chun, Chen Jien-Jiun, Huang Pang-Shuo, Lin Ting-Tse, Cheng Hsiao-Liang, Tsai Chin-Feng, Wang Yi-Chih, Tsai Chia-Ti
Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital Yun-Ling Branch, Dou-Liu City, Taiwan.
Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital Hsin-Chu Branch, Hsin-Chu City, Taiwan.
JACC Asia. 2022 Nov 15;2(6):780-783. doi: 10.1016/j.jacasi.2022.08.003. eCollection 2022 Nov.
Left atrial appendage (LAA) closure (LAAC) device implantation may be challenging in cases with difficult LAA anatomy. A deflectable sheath to approach multiple LAA positions may be helpful. We used a deflectable sheath to implant LAAC devices in 20 patients and included 60 cases using the standard sheaths for comparison. The procedures were successful in all patients without peri-procedural complications. After a median follow-up of 1.52 (IQR: 0.76-2.33) years, none of the patients in the deflectable sheath group had peri-device leak ≥3 mm and experienced thromboembolic stroke. In the standard sheath group, after follow-up of 2.03 (IQR: 0.87-3.19) years, 2 had peri-device leak ≥3 mm and 1 experienced thromboembolic stroke. We first proved the idea of using a universal steerable sheath for LAAC device implantation in difficult LAA anatomy, which also allows rapid switching of different LAAC devices.
在左心耳（LAA）解剖结构复杂的病例中，植入左心耳封堵（LAAC）装置可能具有挑战性。使用可弯曲鞘管到达多个LAA位置可能会有所帮助。我们使用可弯曲鞘管为20例患者植入LAAC装置，并纳入60例使用标准鞘管的病例作为对照。所有患者手术均成功，且无围手术期并发症。在中位随访1.52（四分位间距：0.76 - 2.33）年之后，可弯曲鞘管组中没有患者出现≥3 mm的装置周围渗漏，也没有发生血栓栓塞性卒中。在标准鞘管组中，随访2.03（四分位间距：0.87 - 3.19）年之后，有2例出现≥3 mm的装置周围渗漏，1例发生血栓栓塞性卒中。我们首次证实了在LAA解剖结构复杂的情况下使用通用可操纵鞘管植入LAAC装置的想法，这也允许快速切换不同的LAAC装置。
